SubjectID: 10000980, StudyID: 58636672, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with CKD with increased dyspnea and cough x 2 weeks. // R/o pulmonary edema or infiltrate R/o pulmonary edema or infiltrate

IMPRESSION: As compared to ___, the lung volumes have slightly decreased. Signs of mild overinflation and moderate pleural effusions persist. Moderate cardiomegaly. Elongation of the descending aorta. No pneumonia.

SubjectID: 10000980, StudyID: 58206436, Comparison: worse

WET READ: ___ ___ ___ 6:47 AM 1. New mild pulmonary edema with persistent small bilateral pleural effusions   Keywords: new. 2. Severe cardiomegaly is likely accentuated due to low lung volumes and patient positioning. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: ___F with wheezing and dyspnea. Assess for pulmonary edema.

TECHNIQUE: Single portable upright frontal chest radiograph.

COMPARISON: ___ chest radiograph. ___ chest radiograph.

FINDINGS: In comparison to study performed on of ___ there is new mild pulmonary edema with small bilateral pleural effusions   Keywords: new. Lung volumes have decreased with crowding of vasculature. No pneumothorax. Severe cardiomegaly is likely accentuated due to low lung volumes and patient positioning.

IMPRESSION: 1. New mild pulmonary edema with persistent small bilateral pleural effusions. 2. Severe cardiomegaly is likely accentuated due to low lung volumes and patient positioning.

SubjectID: 10011938, StudyID: 55823081, Comparison: worse

WET READ: ___ ___ 3:25 PM Findings consistent with interstitial pulmonary edema. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___F with SOB and hypoxia. Evaluate for congestive heart failure.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___. CT chest from ___.

FINDINGS: There is mild cardiomegaly with increased pulmonary interstitial markings and pulmonary vascular congestion, consistent with interstitial pulmonary edema   Keywords: increase. There are bilateral mid and lower lung areas of streaky atelectasis. There is no focal consolidation, pneumothorax, or pleural effusions.

IMPRESSION: Findings consistent with interstitial pulmonary edema.

SubjectID: 10011938, StudyID: 54202121, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with eosinophilia and CHF // r/o worsening edema or other acute process

COMPARISON: Radiographs from ___

IMPRESSION: Heart size is enlarged but stable. There is unchanged prominence of the pulmonary interstitial markings consistent with mild pulmonary edema   Keywords: unchanged. No focal consolidation or pneumothoraces are seen.

SubjectID: 10011938, StudyID: 51900145, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman hx of CHF, COPD worsening oxygen requirement // Evidence of pneumonia, CHF

COMPARISON: Radiographs from ___

IMPRESSION: Heart size is enlarged but unchanged. There is again seen mild prominence of the pulmonary interstitial markings suggestive of pulmonary edema, stable   Keywords: stable, again. Subsegmental atelectasis at the lung bases is also seen. There is no definite consolidation. No pneumothoraces are seen.

SubjectID: 10013569, StudyID: 56197670, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Acute heart failure, evaluation for Swan-___ catheter placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the Swan___ catheter, introduced over the right internal jugular vein, is unchanged in position. The tip is located too much distally and should be pulled back by approximately 4 cm. The course of the catheter is unremarkable. Unchanged appearance of the heart and the lung parenchyma, without substantial interval changes. No pneumothorax.

SubjectID: 10013569, StudyID: 52553082, Comparison: better

FINAL REPORT

PORTABLE CHEST FROM ___ AT 8:22 CLINICAL

INDICATION: ___ year old with CHF, assess for interval change.

COMPARISON: ___ at 8:53. A portable upright chest film ___ at 8:22 is submitted.

IMPRESSION: 1. A left-sided pacemaker remains in place. A right subclavian PICC line is unchanged. The right internal jugular Swan-Ganz catheter continues to be in the right pulmonary artery with the tip somewhat distal and a pullback of 3-4 cm has been previously conveyed to the house staff on ___ by Dr. ___ ___, but the position remains unchanged. The heart remains stably enlarged. There has been some interval improvement in but there is persistent mild pulmonary edema   Keywords: improve. No pneumothorax is seen. No focal airspace consolidation is seen to suggest pneumonia. There is likely a layering right effusion with patchy streaky right basilar opacities likely reflectiing compressive atelectasis.

SubjectID: 10018081, StudyID: 59614225, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ___ AT 6:04 A.M. CLINICAL

INDICATION: ___-year-old with bowel ischemia, status post exploratory laparotomy, evaluate for pneumonia. Comparison is made to the patient's prior study dated ___ at 10 p.m. A portable AP upright chest film ___ at 604 is submitted.

IMPRESSION: 1. Nasogastric tube is again seen coursing below the diaphragm with the tip not identified. The heart remains stably enlarged. There is a stable retrocardiac consolidation likely with an associated effusion. In addition, there is more focal patchy opacity developing at the right lung base. Although these findings may represent atelectasis, aspiration and/or bibasilar pneumonia should also be considered. No pneumothorax. No evidence of pulmonary edema.

SubjectID: 10018081, StudyID: 56762822, Comparison: None

WET READ: ___ ___ ___ 10:25 PM As compared to prior chest radiograph from ___, there is increased left retrocardiac opacity which could reflect a combination of pleural effusion, atelectasis and or volume loss. In the appropriate clinical setting, however an early infectious process cannot be excluded. ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST FILM ___ AT 10 P.M. CLINICAL

INDICATION: ___-year-old with respiratory distress, evaluate left chest for decreased breath sounds. Comparison to prior study dated ___ at 927. A portable AP upright chest film ___ at 10 p.m. is submitted.

IMPRESSION: 1. A nasogastric tube is seen coursing below the diaphragm with the tip not identified. There is increasing retrocardiac consolidation with a probable associated effusion. Although this may represent partial lower lobe atelectasis, aspiration and pneumonia should also be considered. Right lung is grossly clear. Heart remains stably enlarged. No pneumothorax is appreciated. No evidence of pulmonary edema.

SubjectID: 10018081, StudyID: 55281127, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old male with altered mental status and rising white count. Evaluate for pneumonia.

COMPARISON: Chest radiograph status through ___.

FINDINGS: Portable AP chest radiograph demonstrates new bibasilar interstial edema with mildly increased vascular congestion   Keywords: new, increase. No focal consolidation identified. There is opacification of the left hemidiaphragm concerning for atelectasis versus pleural effusion. There is no pneumothorax. The cardiomediastinal contour is unchanged in appearance. An enteric tube is seen descending and an uncomplicated course, its terminal end out of view. Chronic deformed right clavicle redemonstrated.

IMPRESSION: Mild interstial edema and vascular congestion.

SubjectID: 10018081, StudyID: 50772344, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM ___ AT 601 CLINICAL

INDICATION: ___-year-old with leukocytosis, left effusion, question pneumonia. Comparison to prior study of ___ at 604. A portable AP upright chest film ___ at 601 is submitted.

IMPRESSION: 1. Nasogastric tube is again seen coursing below the diaphragm with the tip not identified. The heart is stably enlarged. Persistent retrocardiac consolidation and more patchy opacity at the right base remain and are concerning for atelectasis, aspiration or bibasilar pneumonia. Clinical correlation is advised. There is a layering left effusion. No pulmonary edema. No pneumothorax.

SubjectID: 10018081, StudyID: 58536937, Comparison: None

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 5:06 A.M. CLINICAL

INDICATION: ___-year-old with respiratory failure, assess for interval change. Comparison to prior study of ___ at ___. Portable AP semi-erect chest film, ___ at 5:06AM is submitted.

IMPRESSION: 1. Nasogastric tube is again seen coursing below the diaphragm with the tip not identified. Overall cardiac and mediastinal contours are stable. Interval reduction in lung volumes with appearance of patchy opacity at both bases, right greater than left, most likely representing patchy atelectasis in the setting of low lung volumes. No large effusions. No pneumothorax. No evidence of pulmonary edema.

SubjectID: 10018081, StudyID: 57539618, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old male with ventilatory to dependent respiratory insufficiency. Evaluate for interval change.

COMPARISON: Chest radiograph stated through ___.

FINDINGS: Portable chest radiograph demonstrates an endotracheal tube which terminates 4.5 cm above the level of the carina in appropriateposition. A right internal jugular line terminates in the low SVC. An enteric tube descends in in uncomplicated course, its terminal end outside the field of view. Heart size is mildly enlarged, unchanged. New mild interstitial edema in the right lower lobe   Keywords: new. The left lung appears grossly clear and better aerated. No pneumothorax.

IMPRESSION: New mild right lower lobe interstitial edema   Keywords: new.

SubjectID: 10018081, StudyID: 55735807, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old male with bowel ischemia and volume overload. Evaluate interval change.

COMPARISON: Multiple chest radiographs dated through ___.

FINDINGS: Portable frontal chest radiograph demonstrates an endotracheal tube which terminates 4 cm above the level of the carina in appropriate position. An enteric tube descends in an uncomplicated course to the distal esophagus, its end out of view. A right jugular line ends at the low superior vena cava. Allowing for changes in patient positioning, the lungs appear largely unchanged with mildly increased interstitial edema   Keywords: increase. There is no new focal consolidation. There are likely small bilateral pleural effusions, unchanged. There is no pneumothorax.

IMPRESSION: Mildly increased interstitial pulmonary edema   Keywords: increase.

SubjectID: 10018081, StudyID: 58479559, Comparison: None

WET READ: ___ ___ ___ 6:15 PM dobhoff coils in stomach. left basilar opacification is similar or slightly worse than at 4pm but better than at 9am today.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

PATIENT

HISTORY: ___ years old man with pneumatosis, portal/mesenteric venous catheter, status post exploratory laparotomy with extended right colectomy for ischemic colon and prior anastomosis, now status post abdominal closure, ileostomy with Dobbhoff placement.

COMPARISON: Exam is compared to chest x-ray of the same day at 4:00 p.m.

FINDINGS: AP single view portable chest x-ray shows Dobbhoff tube with tip ending in mid gastric cavity. Left lung base opacity has worsened since prior chest x-ray due to increased pleural effusion and left lower lobe collapse. In the appropriate clinical setting pneumonia should be considered. Right lung is clear without consolidation, nodules or pleural effusion. There is no pneumothorax. Heart size is partially obscured by left pleural effusion but appears within normal limits.

IMPRESSION: Correct positioning of Dobbhoff tube ending in mid gastric cavity. Interval increase of left lung base collapse and pleural effusion, is concerning for pneumonia.

SubjectID: 10018081, StudyID: 57747740, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with probable pneumonia. Assess for interval change.

COMPARISON: Chest radiograph from ___ and chest CT from ___ PORTABLE FRONTAL CHEST RADIOGRAPH: There is slight improved aeration of the left lung base as compared to most recent prior radiograph, likely due to decreased atelectasis. However, a moderate consolidation and associated moderate effusion persist and are consistent with the clinical history of pneumonia. There is increased pulmonary vascular congestion, mild, though no overt interstitial edema. There is no pneumothorax. An enteric catheter terminates within the stomach.

IMPRESSION: 1. Unchanged left lower lobe pneumonia, with slightly improved aeration likely due to decreased adjacent atelectasis. 2. Increased mild pulmonary vascular congestion   Keywords: increase.

SubjectID: 10018081, StudyID: 57486705, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is increasing atelectasis at the right lung base. The pleural effusion on the left and the subsequent atelectasis are constant in appearance. Constant size of the cardiac silhouette. Unchanged course of the nasogastric tube.

SubjectID: 10018081, StudyID: 57481090, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: New tachypnea, increasing oxygen requirement, rule out PE.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is noted   Keywords: no relevant change. The lung volumes are low. Atelectasis of the left lower lobe with potential accompanying small left pleural effusion. Unchanged moderate cardiomegaly. No change in appearance of the normal right lung   Keywords: no change. Nasogastric tube is in unchanged position.

SubjectID: 10018081, StudyID: 51961926, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH.

INDICATION: Evaluation of pleural effusions and pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is resolution of the pre-existing right basal atelectasis. Mild pleural effusion on the left, combined to substantial left lower lobe atelectasis. No pneumonia, no overt pulmonary edema. No pneumothorax.

SubjectID: 10018081, StudyID: 58175153, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Sepsis, ischemic bowel disease, intubation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are unchanged. Moderate-to-severe cardiomegaly remains unchanged, but a pre-existing left pleural effusion has slightly decreased in extent. Also decreased is a pre-existing left perihilar opacity. Overall, the lungs appear better ventilated. Plate-like atelectasis at the right lung bases, associated with a small right pleural effusion. No new parenchymal opacities   Keywords: new. No pneumothorax.

SubjectID: 10018081, StudyID: 55554731, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

HISTORY: Arrhythmia. Question central line positioning.

COMPARISONS: Earlier in the same day.

TECHNIQUE: Chest, portable AP upright.

FINDINGS: The patient remains intubated. The endotracheal tube terminates about 5-6 cm above the carina. An orogastric tube courses into the stomach, its distal course not fully imaged. A right internal jugular catheter terminates at the cavoatrial junction. There is a new focal opacity in the left upper lobe with a geometric appearance, probably compatible with atelectasis; a newly forming area of pneumonia is not excluded, however. Dense extensive retrocardiac opacification with air bronchograms and a probable associated pleural effusion persists without clear change. A pleural effusion is not apparent on the right on this study, which may be due to a true decrease or consequence of differences in positioning.

IMPRESSION: New left upper lobe opacity, probably due to atelectasis, but a new focus of infection is not excluded; short-term follow-up radiographs may be helpful to help distinguish if clinical concerns may include the possibility of developing infection. Persistent extensive retrocardiac opacification, most commonly due to atelectasis, with a pleural effusion.

SubjectID: 10018081, StudyID: 53262913, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Ischemic bowel disease, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are unchanged. Unchanged size of the cardiac silhouette. Unchanged bilateral pleural effusions. Unchanged mild-to-moderate fluid overload   Keywords: unchanged.

SubjectID: 10018081, StudyID: 51219318, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post abdominal surgery, evaluation for interval change.

COMPARISON: ___, 5:56 p.m.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are in correct position, except for the endotracheal tube that has been pulled back. The tube now projects approximately 5 cm above the carina with its tip. The patient is rotated. A pre-existing right parenchymal basal opacity therefore appears slightly more extensive than on the previous image. Blunting of the right costophrenic sinus might be artificial. Moderate cardiomegaly persists. Unchanged left lower lobe atelectasis.

SubjectID: 10018081, StudyID: 50515796, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Endotracheal tube placement, evaluation.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. On the current image, the tip of the endotracheal tube projects approximately 6 cm above the carina. Unchanged size of the cardiac silhouette. Retrocardiac atelectasis. Minimal right basal atelectasis but no convincing evidence of pneumonia. Mild fluid overload, no overt pulmonary edema.

SubjectID: 10018081, StudyID: 55879987, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Study of earlier the same date.

FINDINGS: Dobbhoff tube has been replaced, and is malpositioned with coiling in the mid thoracic esophagus and distal tip directed cephalad at the cervicothoracic junction. At the time of this dictation, subsequently obtained chest x-rays document re-positioning. Cardiomediastinal contours are stable, and there is worsening left retrocardiac opacity adjacent to an unchanged left pleural effusion. Patchy atelectasis at the right lung base is new. Otherwise, no relevant short interval change   Keywords: no relevant short interval change.

SubjectID: 10018081, StudyID: 55605617, Comparison: None

FINAL REPORT

PORTABLE SEMI-UPRIGHT CHEST, ___

COMPARISON: ___.

FINDINGS: Persistent left retrocardiac opacity, with increasing volume loss manifested by inferior displacement of the left hilum and apparent displacement of left major fissure, consistent with left lower lobe atelectasis. Coexisting pneumonia is possible in the appropriate clinical setting. Right lung and pleural surfaces are clear.

SubjectID: 10018081, StudyID: 53437264, Comparison: same

FINAL REPORT

PORTABLE CHEST OF ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Worsening left retrocardiac opacity, most likely due to atelectasis, although coexisting infectious consolidation is possible in the appropriate clinical setting. Otherwise, similar appearance of the chest compared to the previous radiograph performed several hours earlier   Keywords: similar appearance.

SubjectID: 10018081, StudyID: 52015079, Comparison: same

FINAL REPORT

PORTABLE CHEST ___, ___

COMPARISON: Study of one day earlier.

FINDINGS: Interval repositioning of Dobbhoff tube, now terminating in the stomach. Improving left retrocardiac atelectasis, and near resolution of patchy right basilar atelectasis. Otherwise, no relevant change since the recent study performed about two hours earlier   Keywords: no relevant change.

SubjectID: 10018081, StudyID: 56942504, Comparison: worse

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___M with oxygen requirement, crackles at bases // ?pulmonary edema, pna

TECHNIQUE: Chest Frontal and Lateral

COMPARISON: ___

FINDINGS: Left-sided PICC is again seen, terminating in the mid SVC. The cardiac silhouette remains moderate to severely enlarged. Bibasilar opacities have increased in there is now a blunting of the costophrenic angles   Keywords: increase. Findings are consistent with small to moderate bilateral pleural effusions with overlying atelectasis, underlying consolidation due to pneumonia is not excluded. There is moderate pulmonary edema. No pneumothorax.

IMPRESSION: Bilateral pleural effusions, pulmonary edema, and marked enlargement of the cardiac silhouette suggest CHF, however underlying consolidation due to pneumonia at the lung bases not excluded in the appropriate clinical setting.

SubjectID: 10018081, StudyID: 55297211, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___M CHF, admitted for respiratory distress // compare to prior

COMPARISON: ___.

IMPRESSION: Pulmonary edema has nearly resolved, with associated resolving right pleural effusion   Keywords: resolve. Stable cardiomegaly, and small left pleural effusion with adjacent basilar atelectasis.

SubjectID: 10018081, StudyID: 55937781, Comparison: None

FINAL REPORT

EXAMINATION: Portable Chest Radiograph

INDICATION: ___M s/p end ileostomy takedown now with ulceration of esophagus and duodenum // assess for free air, interval changes

TECHNIQUE: Portable CXR

COMPARISON: Portable CXR ___

FINDINGS: Since the prior CXR, there has been interval placement of a enteric tube that extends to at least the stomach, but the distal tip is beyond the inferior margin of the image. There is a moderate-sized left pleural effusion that appears slightly worse than ___. A small right-sided pleural effusion is also noted. There is pulmonary vascular congestion with mild pulmonary edema. No evidence of pneumothorax. The previously seen pneumoperitoneum has now resolved. Heart appears mildly enlarged, unchanged from prior. No acute osseous abnormalities.

IMPRESSION: 1. Interval resolution of small pneumoperitoneum. 2. Worsening left-sided pleural effusion.

SubjectID: 10018081, StudyID: 52241060, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man s/p ileostomy take down. Crackles on exam, concern for consolidation // pulmonary edema vs. pneumonia

COMPARISON: Chest radiograph from ___.

FINDINGS: AP portable upright view of the chest. Trace pneumoperitoneum is within post surgical limits. The heart is mildly enlarged. The hilar and mediastinal contours are within normal limits. A retrocardiac left basilar opacity likely reflects atelectasis. There is no pneumothorax. Tiny bilateral pleural effusions are present.

IMPRESSION: 1. Left retrocardiac opacity, likely representing atelectasis. Small consolidations in this area cannot be excluded. 2. Trace pneumoperitoneum, within post surgical limits. 3. Trace bilateral pleural effusions.

SubjectID: 10018081, StudyID: 55764579, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with fever to 102.4, POD___ s/p ileostomy takedown, returned with ?ECF // ?acute process

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Left PICC line tip is at the level of mid SVC. Cardiomegaly and mediastinum are unchanged. Right basal opacity has slightly progressed. Left retrocardiac atelectasis is unchanged. Upper zone re- distribution of the vasculature is unchanged

SubjectID: 10018081, StudyID: 53134267, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: History of ischemic colitis status post right hemicolectomy and ileocolic anastomosis, presenting with feculent material at surgical wound site. Question PICC line placement.

COMPARISONS: ___.

TECHNIQUE: Chest, portable AP semi-upright, single view.

FINDINGS: The cardiac, mediastinal and hilar contours appear unchanged. There is again borderline cardiomegaly. Allowing for rotation as well as scoliosis, the cardiac, mediastinal and hilar contours are probably unchanged. There is similar mild relative elevation of the left hemidiaphragm. There is no definite pleural effusion or pneumothorax. The lungs appear clear. A PICC line terminates in the lower superior vena cava.

IMPRESSION: PICC line terminating in the lower superior vena cava. No evidence of acute disease.

SubjectID: 10023117, StudyID: 59984631, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cardiopulmonary failure // Interval change in intubated patient Interval change in intubated patient

IMPRESSION: Comparison to ___. The patient has been extubated and the nasogastric tube was removed. Moderate cardiomegaly persists. The pacemaker is in stable position. Also stable is the left-sided Swan-Ganz catheter. No pulmonary edema, minimal atelectasis at the right lung basis is stable.

SubjectID: 10023117, StudyID: 55383014, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with non-ischemic cardiomyopathy and EF ___% in cardiogenic shock, intubated // volume status.

TECHNIQUE: Single frontal view of the chest.

COMPARISON: Chest radiograph dated ___.

FINDINGS: Compared chest radiograph from ___, there is little overall change   Keywords: little overall change. Swans-Ganz catheter, ETT and esophageal drainage tubes are unchanged in standard placements. Left cardiac pacing/defibrillator device with transvenous right atrial, right ventricular and coronary sinus/left ventricular leads in unchanged position. Right basilar atelectasis has worsened. Left retrocardiac opacification minimally changed and probably reflects a combination of pleural effusion and atelectasis. There is no pneumothorax. There is no vascular engorgement or pulmonary edema.

IMPRESSION: 1. No evidence of vascular engorgement or cardiac decompensation. 2. Worsening right basal atelectasis. Unchanged left basal atelectasis.

SubjectID: 10023117, StudyID: 54147385, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sCHF and swan in place // swan placement, ?fluid overload, pneumo, potential consolidation concerning for pneumonia swan placement, ?fluid overload, pneumo, potential consolidation concerning for pneumonia

IMPRESSION: In comparison with the study of ___, the monitoring and support devices are unchanged. Swan-Ganz catheter again extends well into the left pulmonary artery system. Continued enlargement of the cardiac silhouette without appreciable vascular congestion, a discordance that raise the possibility of cardiomyopathy. No acute focal pneumonia.

SubjectID: 10023117, StudyID: 59383121, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post chest tube removal. Evaluation for interval change.

FINDINGS: As compared to the previous image, there is minimally improved ventilation at both the left and right lung base. Plate-like atelectasis at the level of the left hilus. Normal size of the cardiac silhouette. No evidence of pneumothorax.

SubjectID: 10023117, StudyID: 56007252, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Decompensated chronic heart failure, persistent oxygen requirements.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the gastric distention has decreased. There is unchanged evidence of low lung volumes with areas of atelectasis at the lung bases. The ECG cables, pacemaker wires and right PICC line are constant. Unchanged moderate cardiomegaly. No new parenchymal opacities in the ventilated lung zones   Keywords: new. No pneumothorax.

SubjectID: 10023117, StudyID: 54404075, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Decompensated heart failure, leukocytosis. Evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is no relevant change   Keywords: no relevant change. Moderate cardiomegaly with moderate pulmonary edema. The areas of increased density at the right lung base are minimally progressive. No new parenchymal opacities   Keywords: new. No pneumothorax.

SubjectID: 10023117, StudyID: 50447167, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with recent surgery and hypoxia, rule out pneumothorax.

COMPARISON: ___.

FINDINGS: There is no pneumothorax. Left-sided pacemaker has three leads, one in right atrium, one in right ventricle and the last one in the coronary sinus. Left jugular line is at the junction of brachiocephalic vein and superior vena cava. Right-sided PICC line is still looped in the distal subclavian vein and ends in the upper SVC. Bibasilar consolidation which is probably atelectasis is unchanged. Moderate cardiomegaly is stable. The stomach is more dilated than previous exam.

CONCLUSION: 1. There is no pneumothorax. 2. Right-sided PICC line is still looped inside the subclavian vein. 3. Unchanged bibasilar consolidation. This was discussed with the medical team.

SubjectID: 10023117, StudyID: 52880779, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Right subclavian stick for right atrial lead implantation, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received an additional pacemaker lead. There is no evidence of right pneumothorax and no evidence of right mediastinal widening. At the right lung bases, an area of atelectasis persists in unchanged manner as compared to the previous radiograph. No pleural effusions. Moderate cardiomegaly without evidence of acute pulmonary edema.

SubjectID: 10023117, StudyID: 50130952, Comparison: None

FINAL REPORT

PA AND LATERAL CHEST ___

HISTORY: Right subclavian insertion attempt for right atrial lead.

IMPRESSION: PA and lateral chest compared to ___ through ___: No pneumothorax, pleural effusion or new mediastinal widening. Right middle lobe collapse and extensive extrapleural fat deposition are chronic findings. Moderate cardiomegaly is also longstanding. Lungs are grossly clear and there is no pulmonary edema. Transvenous right atrial and left ventricular pacer and right ventricular pacer defibrillator leads are unchanged since ___ which showed replacement of the previous left ventricular lead and insertion of a new one in the right atrium.

SubjectID: 10055694, StudyID: 59844689, Comparison: same

FINAL REPORT

INDICATION: New shortness of breath with history of congestive heart failure.

COMPARISON: ___. PA AND LATERAL VIEWS OF THE CHEST: The heart size is moderately enlarged, but the cardiac silhouette is obscured due to the presence of a moderate-to-large right pleural effusion with right basilar compressive atelectasis. Mild pulmonary edema appears relatively unchanged compared to prior study. No left-sided pleural effusion is visualized. There is no acute osseous abnormality.

IMPRESSION: Moderate-to-large right pleural effusion, slightly increased from prior, with right basilar atelectasis. Mild pulmonary edema, unchanged   Keywords: unchanged.

SubjectID: 10062617, StudyID: 54889099, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sick sinus syndrome s/p PM placement, now with fever and prior aspiration events // R/o aspiration pneumonia

COMPARISON: ___, 00:08.

IMPRESSION: As compared to the previous image, no relevant change is seen   Keywords: no relevant change. The pacemaker leads are in constant position. Moderate cardiomegaly persists. No overt pulmonary edema. No pneumonia, no pleural effusions. Moderate elongation of the descending aorta.

SubjectID: 10062617, StudyID: 50247193, Comparison: None

FINAL REPORT

INDICATION: ___ year old male with shortness of breath, new oxygen requirement

TECHNIQUE: Frontal chest radiographs were obtained with the patient in the upright position.

COMPARISON: Chest radiograph from ___, ___ and ___.

FINDINGS: The lungs are clear of focal consolidation or pneumothorax. There is a small left pleural effusion or pleural thickening. The heart continues to be enlarged, and there is a left cardiac pacer device is with leads terminating in appropriate position. The mediastinal contours are normal. Outpouching of the left hemidiaphragm may reflect a hiatal hernia or eventration which can be better assessed with a conventional PA radiograph.

IMPRESSION: No pneumonia or pulmonary edema. Small left pleural effusion or pleural thickening.

SubjectID: 10088198, StudyID: 58224105, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Bilateral effusions, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a mild increase in extent of the known left pleural effusion and a stable appearance of the right pleural effusion. Increasing atelectasis at both lung bases. Unchanged size of the cardiac silhouette. The position of the central access line is constant.

SubjectID: 10088198, StudyID: 56308459, Comparison: None

FINAL REPORT

HISTORY: Chest tube removal, to assess for pneumothorax.

FINDINGS: In comparison with study of ___, the monitoring and support devices have been removed. Following the chest tube removal, there is no pneumothorax. There is a hazy opacification bilaterally with poor definition of the diaphragms, consistent with layering pleural effusions. No definite vascular congestion. Poor definition of the left hemidiaphragm in the retrocardiac region is consistent with volume loss in the left lower lobe.

SubjectID: 10088198, StudyID: 55536724, Comparison: None

WET READ: ___ ___ ___ 10:43 PM No significant change in the bilateral pleural effusions and basilar opacities, likely atelectasis, though a superimposed pneumonia would be difficult to exclude in the proper clinical setting. No definite pulmonary edema, as the apices remain clear. Unchanged cardiomegaly.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

HISTORY: Patient with desaturation, eval for volume overload.

COMPARISON: Portable chest radiograph performed earlier on the same day on ___.

FINDINGS: Portable single frontal chest x-ray was performed with the patient in upright position. Compared to earlier study, there has been no significant interval change in the moderate bilateral pleural effusions and associated bibasilar atelectasis. Lung volumes are low. The heart remains moderately enlarged. There is no pneumothorax or pulmonary edema. A left subclavian central line has been removed. Median sternotomy wires are intact.

IMPRESSION: No interval change in the appearance of the heart and lungs.

SubjectID: 10088198, StudyID: 57430622, Comparison: None

FINAL REPORT

INDICATION: History of aortic and mitral valve debridement status post tap of right pleural effusion. Please evaluate for interval change.

COMPARISON: Chest radiograph from ___.

TECHNIQUE: Single AP portable exam of the chest.

FINDINGS: There has been significant interval improvement of the large right pleural effusion with residual right basilar atelectasis. There is mild stable left basilar atelectasis. There is no evidence of a pneumothorax. The cardiomediastinal contours are otherwise unremarkable.

IMPRESSION: Interval improvement of the large right pleural effusion, stable small left pleural effusion, no evidence of a pneumothorax.

SubjectID: 10088198, StudyID: 53585599, Comparison: better

FINAL REPORT

INDICATION: History of CABG, please evaluate for effusion.

COMPARISONS: Multiple chest radiographs dated back to ___.

TECHNIQUE: AP and lateral exam of the chest.

FINDINGS: The lung volumes are low. There is prominence of the upper zone vessels, slightly improved compared to the prior exam, compatible with pulmonary vascular congestion. Again seen are moderate-sized layering bilateral pleural effusions, overall unchanged compared to the prior exam with associated compressive atelectasis. Nodular opacities at the right apex are unchanged. Median sternotomy wires are intact.

IMPRESSION: Stable bilateral moderate pleural effusions however with mild interval improvement of the pulmonary vascular congestion   Keywords: improve.

SubjectID: 10095181, StudyID: 52185486, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Pancreatic cancer, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the vertebral fixation devices in the right-sided Port-A-Cath are in constant position. The pre-existing parenchymal opacities have slightly decreased in extent and severity   Keywords: decrease. Also, a component of minimal interstitial fluid overload is less severe than on the previous image   Keywords: less severe. Unchanged cardiac silhouette. No pleural effusions.

SubjectID: 10095181, StudyID: 51836845, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for pneumonia or pleural effusions.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have slightly decreased. The diffuse bilateral parenchymal opacities, right more than left, are unchanged in extent and distribution   Keywords: unchanged. Increasing atelectasis at the left lung base. The size of the cardiac silhouette is constant.

SubjectID: 10095181, StudyID: 51702229, Comparison: worse

FINAL REPORT

INDICATION: Hypoxia, assess for pneumonia.

COMPARISONS: Chest radiograph of ___ and chest CT of ___.

FINDINGS: Frontal and lateral views of the chest demonstrate low lung volumes. Diffuse bilateral opacities have progressed since prior exams   Keywords: progressed. There is small left pleural effusion. Hilar and mediastinal silhouettes are unchanged. Heart size is top normal. Aortic arch calcifications are noted. Right Port-A-Cath tip projects over proximal right atrium. Surgical clips and biliary stent project over right upper abdomen. Cervical fixation hardware is in place.

IMPRESSION: Diffuse bilateral opacities, most likely pulmonary edema, have progressed since prior studies   Keywords: progressed. However, superimposed infection cannot be excluded in the appropriate clinical setting.

SubjectID: 10095181, StudyID: 50494469, Comparison: same

FINAL REPORT

PORTABLE CHEST FILM, ___ AT 5:17

INDICATION: ___-year-old with sepsis, question pneumonia or edema. Comparison is made to the patient's prior study of ___ at 11:46. A portal semi-upright chest film ___ at 5:17 a.m. is submitted.

IMPRESSION: 1. Right subclavian Port-A-Cath continues to have its tip in the distal SVC. There continue to be diffuse bilateral parenchymal and interstitial opacities, which are likely not significantly changed, although there is some improvement in aeration   Keywords: continue, not significantly changed. There is likely a layering left effusion. No pneumothorax. Overall cardiac and mediastinal contours are likely unchanged given differences in positioning. Hardware is seen overlying the lower cervical spine. No pneumothorax.

SubjectID: 10106899, StudyID: 57131579, Comparison: better

FINAL REPORT

INDICATION: ___-year-old female with CAD status post recent NSTEMI, admitted for CHF exacerbation, now requiring assessment for interval change.

COMPARISON: Comparison is made with chest radiograph from ___.

FINDINGS: Pulmonary vasculature is less dilated and there is less pulmonary edema than on prior exam   Keywords: less pulmonary edema. There is a right pleural effusion. There is plate atelectasis in the left mid zone. The right ventricle pacer wire passes in a supero-oblique direction within the heart instead the usual infero-oblique direction. There is no pneumothorax. Heart size cannot be assessed due to bilateral bibasilar opacities. There is a possibility that there an underlying pneumonia hidden by the pleural effusion and pulmonary edema. Recommend followup imaging as the edema clears.

IMPRESSION: Right pleural effusion. Left basilar plate atelectasis. Improving pulmonary edema   Keywords: improving. Recommend followup chest imaging to rule out pneumonia after pulmonary edema has cleared.

SubjectID: 10106899, StudyID: 55149307, Comparison: None

FINAL REPORT

HISTORY: Acute onset of dyspnea. Evaluate for heart failure versus infection.

TECHNIQUE: Single frontal view of the chest.

COMPARISON: None.

FINDINGS: The cardiac silhouette is indistinct. Hazy perihilar opacities and ill-defined pulmonary vascular markings are consistent with pulmonary edema. Blunting of the costophrenic angles and basilar opacities are compatible with moderate-sized pleural effusions and bibasilar atelectasis. Narrowing of the right acromiohumeral interval is consistent with rotator cuff injury. Deformity of the distal right clavicle is compatible with a prior injury at this location. Leads of a right chest wall pacer terminate over the right atrium and ventricle.

IMPRESSION: Pulmonary edema with moderate-sized bilateral pleural effusions and atelectasis.

SubjectID: 10122589, StudyID: 59846275, Comparison: same

FINAL REPORT

INDICATION: ___-year-old male with multifocal pneumonia, assess for interval change.

COMPARISONS: Chest radiographs dating back to ___, most recent from ___. PORTABLE SUPINE CHEST RADIOGRAPH: A right approach PICC terminates at the cavoatrial junction, unchanged. Severe consolidation of the entire right lung appears similar to most recent prior examination and is likely a combination of pneumonia and pleural fluid. Interstitial edema within the left lung remains moderate. A small left pleural effusion is likely. Additional left basilar opacities may reflect additional foci of infection. Apical thickening bilaterally is unchanged. Cardiomediastinal and hilar contours remain mildly enlarged.

IMPRESSION: Ongoing severe right lung consolidation, a combination of pneumonia and edema. Bilateral moderate effusions are likely. No significant change compared to most recent prior   Keywords: no significant change.

SubjectID: 10122589, StudyID: 52495824, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male with pneumonia, assess for interval change.

COMPARISON: Chest radiographs dating back to ___, most recent from ___. PORTABLE SEMI-ERECT FRONTAL CHEST RADIOGRAPH: A right approach PICC terminates in the low SVC. Overall aeration of the lungs is significantly improved compared to most recent prior examination. There is decreased density of the right lung consistent with resolving aspiration. Subtle opacity within the left base may be related to additional areas of aspiration or atelectasis. There is no pneumothorax. Mild enlargement of cardiomediastinal contours is unchanged. A calcified right pleural plaque at the lung base is unchanged.

IMPRESSION: Improved aeration of the lungs, findings compatible with resolving right lower lung aspiration.

SubjectID: 10122589, StudyID: 59058941, Comparison: same

FINAL REPORT

HISTORY: CHF.

FINDINGS: In comparison with the study of ___, the monitoring and support devices remain in place. Again, there are diffuse bilateral pulmonary opacifications, somewhat more prominent on the right   Keywords: again. This could reflect pulmonary edema, though the possibility of superimposed pneumonia would be a strong possibility in the appropriate clinical setting. Coarse reticular changes at the bases are again consistent with fibrotic lung disease. There is pleural plaquing and bilateral pleural effusions.

SubjectID: 10122589, StudyID: 56104045, Comparison: None

FINAL REPORT

HISTORY: Pulmonary edema and pneumonia.

FINDINGS: In comparison with study of ___, the left IJ catheter has been removed. There is continued prominence of the cardiac silhouette with evidence of elevated pulmonary venous pressure. Extensive pleural calcifications again seen, along with bibasilar atelectasis or pneumonia and left effusion.

IMPRESSION: Severe pulmonary edema as seen on the recent CT scan.

SubjectID: 10122589, StudyID: 55266455, Comparison: None

FINAL REPORT

TYPE OF

EXAMINATION: Chest AP portable single view.

INDICATION: ___-year-old male patient with replaced orogastric tube as previous tube was malfunctioning.

FINDINGS: AP single view of the chest has been obtained with patient in sitting semi-upright position. Analysis is performed in direct comparison with the next preceding similar study obtained 12 hours earlier during the same day. During the interval, the patient has been extubated. Previously described left internal jugular approach central venous line remains in unchanged position. No pneumothorax is seen. No OG or NG tube can be identified below the level of the chest apex. General chest findings are unaltered in comparison with the previous study. Referring physician, ___ ___, was paged at 4:20 p.m.No answer received until 5:15 pm.Apparently the tube placement has failed.

SubjectID: 10122589, StudyID: 54937253, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of earlier the same date.

FINDINGS: Interval intubation with tip of endotracheal tube terminating 3 cm above the carina. The left lung volumes are increased compared to the prior pre-intubation radiograph, and there is associated improved aeration at the lung bases. Otherwise, widespread pulmonary parenchymal and pleural abnormalities appear similar to the recent radiograph performed a few hours earlier. Note is also made of interval placement of nasogastric tube, terminating within the stomach.

SubjectID: 10122589, StudyID: 52417409, Comparison: worse

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Interval extubation and removal of nasogastric tube. Widening of vascular pedicle is accompanied by pulmonary vascular congestion and worsening bilateral asymmetrically distributed airspace opacities, involving the right lung to a greater degree than the left   Keywords: worse. These findings may be due to pulmonary edema with or without coexisting pneumonia. Calcified pleural plaques and pleural thickening are present, as well as a homogeneous opacity at the left apex, not fully characterized on this portable radiograph but similar to ___. Coarse reticular opacities at the lung bases suggest the presence of fibrotic lung disease, but are difficult to assess in the setting of superimposed acute abnormalities.

SubjectID: 10122589, StudyID: 53271877, Comparison: same

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Allowing for differences in technique and projection, there has been little change in the appearance of the chest except for slight improved aeration in the left retrocardiac region   Keywords: little change.

SubjectID: 10122589, StudyID: 53075201, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Study of ___.

FINDINGS: Multifocal consolidation in the right lung has progressed in the interval, particularly in the right upper lobe. A dominant rounded opacity in this region has an eccentric lucency suggesting new possibility of cavitation, a finding that could be confirmed or excluded by CT if warranted clinically. Pulmonary vascular congestion and interstitial edema are also noted as well as bilateral areas of pleural thickening, some of which are calcified, suggesting previous asbestos exposure. Asymmetrical biapical thickening, left greater than right, is a longstanding finding based on review of older radiograph of ___.

SubjectID: 10152675, StudyID: 59743592, Comparison: None

WET READ: ___ ___ 1:00 PM Malpositioned nasogastric tube in the pharynx needs to be repositioned. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hyoercalcemia, hypernatremia with new NGT // Ngt placement

COMPARISON: ___

IMPRESSION: A newly placed feeding tube is coiled in the pharynx. The tube does not reach the esophagus. Tube reposition is required.

SubjectID: 10152675, StudyID: 56678828, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with afib on coumadin, MGUS, Gaucher's disease, CAD, and CHF presenting with labored breathing, diffuse rhonchi and hypoxia. Not resposive to deep suctioning. // Evaluate for pneumonia, pulmonary edema, aspiration? Evaluate for pneumonia, pulmonary edema, aspiration?

IMPRESSION: In comparison with the study of ___, the patient is oblique to the left. This may account for the apparent increase in opacification at the left base with poor definition of the hemidiaphragm. Otherwise little change   Keywords: little change.

SubjectID: 10152675, StudyID: 54234805, Comparison: None

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old man with ngt placement // NGT placement

TECHNIQUE: Portable chest radiograph

COMPARISON: Chest x-ray ___ at 10:50.

FINDINGS: Since the prior radiograph performed 2 hours earlier, there has been interval repositioning of the NG tube, which now terminates in the stomach. The right-sided PICC line terminates at the cavoatrial junction. Improving right lung base opacity, and stable appearance of left lung base opacity. There is no pneumothorax. Cardiomediastinal silhouette is mildly enlarged. Atherosclerotic calcifications noted in the aortic arch.

IMPRESSION: Repositioned NG tube now terminates in the stomach.

SubjectID: 10152675, StudyID: 51956328, Comparison: None

FINAL REPORT

EXAMINATION: PORTABLE CHEST RADIOGRAPH

INDICATION: ___-year-old male with acute change in mental status.

TECHNIQUE: Frontal semi-upright chest radiograph

COMPARISON: Chest radiograph from ___.

FINDINGS: Assessment is limited due to positioning. Allowing for this limitation, there patchy pulmonary opacities in the left mid lung and the left base, overlying the region of the apex in this radiograph, with obscuration of the lateral hemidiaphragm. Right basilar streaky opacities may represent chronic fibrosis and associated atelectasis. There is no pneumothorax. Heart size cannot be properly assessed in this exam.

IMPRESSION: Findings compatible with left lower lobe pneumonia.

SubjectID: 10152675, StudyID: 51914560, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: Evaluation for left lower lobe pneumonia

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the image quality is improved. Low lung volumes. Borderline size of the cardiac silhouette. Aortic wall calcifications. No left basal parenchymal opacity, no evidence of pneumonia. No pulmonary edema. No pleural effusions.

SubjectID: 10186442, StudyID: 59891152, Comparison: same

FINAL REPORT

HISTORY: Stroke with elevated white count.

FINDINGS: In comparison with the study of ___, the Dobbhoff tube has been removed. There is again hazy opacification at the bases consistent with layering effusions and compressive atelectasis at the base. Enlargement of the cardiac silhouette with pulmonary vascular congestion persists   Keywords: persists.

SubjectID: 10186442, StudyID: 53681192, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with amyloid cardiomyopathy and diffuse pleural edema s/p large right MCA stroke. // eval pleura edema vs pneumo after diuresis

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is a minimal decrease in extent and severity of the bilateral pleural effusions. However, moderate cardiomegaly and mild to moderate pulmonary edema persists   Keywords: persists. No new parenchymal opacities   Keywords: new.

SubjectID: 10186442, StudyID: 56380789, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with recent extubation // ?interval worsening of effusions

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the patient has been extubated. The right PICC line remains in unchanged position. The pigtail catheter on the left has been removed. Mild cardiomegaly. Mild pulmonary edema and bilateral pleural effusions are visualized on today's image.

SubjectID: 10186442, StudyID: 53159896, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with afib and some volume overload // eval for interval change in pulmonary edeam and pleural effusions

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, there is increasing evidence of pulmonary edema with increasing bilateral pleural effusions and appearance of multiple air bronchograms, predominantly in the right perihilar lung zones   Keywords: increasing. The size of the cardiac silhouette is unchanged. Unchanged position of the right PICC line.

SubjectID: 10186442, StudyID: 55286642, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman intubated for hypoxemic respiratory failure // eval for interval change

TECHNIQUE: Portable semi-erect

COMPARISON: Chest films dating back to ___

FINDINGS: ET tube is 3.5 cm above the carinal. NG tube is seen in the stomach and goes out of view. Left chest pigtail catheter is seen terminating in the basal left lung. Right moderate pleural effusion is smaller since prior. Pulmonary vascular congestion is unchanged as compared to prior   Keywords: unchanged. There is moderate cardiomegaly.

IMPRESSION: Smaller moderate right pleural effusion, moderate cardiomegaly which is unchanged, and vascular congestion which is stable   Keywords: unchanged, stable.

SubjectID: 10186442, StudyID: 51406748, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___-year-old female with respiratory failure. Evaluate for worsening edema.

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: ___.

FINDINGS: ET and enteric tubes remain in satisfactory position. Moderate to severe pulmonary edema is unchanged   Keywords: unchanged. Moderate bilateral layering pleural effusions appear slightly larger on today's exam. There is no pneumothorax. The heart and mediastinum cannot be accurately assessed due to projection and significant airspace disease. Regional bones and soft tissues are unremarkable.

IMPRESSION: Stable moderate to severe pulmonary edema   Keywords: stable. Slight interval increase in moderate layering bilateral pleural effusions.

SubjectID: 10186442, StudyID: 50490042, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hypoxic respiratory failure // ?interval worsening

COMPARISON: ___

IMPRESSION: As compared to the previous image, the nasogastric tube has been removed. The endotracheal tube, the left pleural pigtail catheter as well as the right PICC line are still visualized, the PICC line has been pulled back by several cm and the tip now projects over the mid to lower SVC. Improvement in the extent of bilateral pleural effusions, with subsequent improvement of pulmonary ventilation. However, mild pulmonary edema and areas of atelectasis, predominantly at the lung bases, are still visualized. Unchanged borderline size of the cardiac silhouette.

SubjectID: 10186442, StudyID: 50275370, Comparison: None

FINAL REPORT

INDICATION: History: ___F with et tube // eval tube placement

TECHNIQUE: AP portable view of the chest

COMPARISON: ___ chest radiograph

FINDINGS: ET tube ends 4.6 cm from the carina. Enteric tube is off the inferior portion of the image. There is left lower lobe collapse. There are small bilateral pleural effusions, with a significant decrease in the size of the left pleural effusion. There is mild pulmonary edema. No pneumothorax.

IMPRESSION: ET tube in appropriate position. Left lower lobe collapse. Mild pulmonary edema. Small bilateral pleural effusions, the left pleural effusion has decreased.

SubjectID: 10191971, StudyID: 59497040, Comparison: worse

FINAL REPORT

HISTORY: Hypoxemia, cough, shortness of breath.

TECHNIQUE: Upright AP and lateral views of the chest.

COMPARISON: ___.

FINDINGS: The heart size is normal. The mediastinal contour is unchanged. Fullness of the hila bilaterally along with widespread perihilar ill-defined opacities and more focal opacification in the right lung base appear slightly progressed in the interval   Keywords: progressed. No pneumothorax is demonstrated. Small right pleural effusion is noted. There is no acute osseous abnormality.

IMPRESSION: Slight worsening of widespread perihilar and right basilar opacities reflective of lymphomatous infiltration with superimposed bronchitis. More focal opacity in the right lung base is concerning for pneumonia. Small right pleural effusion.

SubjectID: 10191971, StudyID: 52938081, Comparison: better

FINAL REPORT

HISTORY: ET position.

FINDINGS: In comparison with the study of ___, the monitoring and support devices are essentially unchanged. The tip of the endotracheal tube lies approximately 5.2 cm above the carina. Cardiac silhouette remains within normal limits. There is some further improvement in the right basilar opacification as well as a slight improvement in the degree of pulmonary vascular congestion   Keywords: improve.

SubjectID: 10191971, StudyID: 58837043, Comparison: None

FINAL REPORT

INDICATION: History of peripheral T-cell lymphoma, possible pneumonia. Interval worsening on chest x-ray.

COMPARISON: Chest radiographs from ___.

FINDINGS: A single portable chest radiograph was provided. There has been improvement in the left and right hilar opacities, likely representing combination of pneumonia and lymphadenopathy. There is left basilar atelectasis. Cardiomediastinal silhouette is unchanged. No pneumothorax or pleural effusions are present.

IMPRESSION: Improvement in right perihilar opacity consistent with improving infection.

SubjectID: 10191971, StudyID: 56265061, Comparison: same

FINAL REPORT

HISTORY: T-cell lymphoma, now with dyspnea, cough, and hoarseness.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

COMPARISON: Comparison is made to radiographs dated ___.

FINDINGS: Interval removal of a previous left PICC line. A zone of minimally increased density is seen in the ight lower lobe, concerning for a possible consolidation. Bilateral, perihilar lymphadenopathy is noted, unchanged in appearance from prior examination   Keywords: unchanged in appearance. There is no pleural effusion, pneumothorax, or pulmonary edema. The heart size is normal. Mediastinal contours are stable.

IMPRESSION: Right lower lobe consolidation, concerning for early pneumonia. Findings were entered into the radiology dashboard by Dr. ___ at 1:22pm on ___, 5 minutes after discovery.

SubjectID: 10191971, StudyID: 54903696, Comparison: better

FINAL REPORT

HISTORY: Peripheral T-cell lymphoma and COPD with hypoxic respiratory failure and pneumonia.

COMPARISON: Multiple prior chest radiographs, most recently ___.

FINDINGS: Single frontal view of the chest. Endotracheal tube, NG tube, and right IJ central venous catheter are in stable position. Pulmonary congestion has improved since the prior exam with decreased prominence of the pulmonary vascular markings   Keywords: improve, decrease. Masslike consolidation in the right lower lung with central adenopathy is similar to prior. No pneumothorax. Heart size is normal and minimal widening of the vascular pedicle is stable.

IMPRESSION: Interval improvement of pulmonary vascular congestion with stable right lower lung masslike consolidation   Keywords: improve.

SubjectID: 10194132, StudyID: 56569744, Comparison: None

FINAL REPORT

INDICATION: History: ___M with change in meds reports no duiresis // r/o chf

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___.

FINDINGS: Lung volumes are low resulting in crowding of the pulmonary vasculature. No definite consolidation concerning for pneumonia is identified. Small bilateral effusions are new. There is no evidence of pneumothorax.

IMPRESSION: New small bilateral pleural effusions.

SubjectID: 10194132, StudyID: 54186312, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF exacerbation and increasing dyspnea. // Signs of pulmonary edema vs. other pulmonary process

TECHNIQUE: Portable upright chest radiograph

COMPARISON: ___ at 01:50

FINDINGS: Since the prior study there are new interstitial opacities in the mid lung fields bilaterally, right greater than left   Keywords: new. Lung volumes are low, as before. Heart size is moderately enlarged, as before. No large pleural effusion.

IMPRESSION: Increased interstitial opacities bilaterally, right greater than left, representing pulmonary edema   Keywords: increase. Moderate stable cardiomegaly.

SubjectID: 10194776, StudyID: 58707049, Comparison: better

FINAL REPORT

PORTABLE CHEST FILM ___ AT 811 CLINICAL

INDICATION: ___-year-old with question pulmonary edema, question new infiltrates. Comparison is made to the patient's previous study dated ___. A portable AP upright chest film ___ at 811 is submitted.

IMPRESSION: 1. Feeding tube and left-sided dual-lead pacer remain in place. Stable cardiac enlargement. Calcification of the aortic knob and descending aorta consistent with atherosclerosis. Overall, there continues to be a diffuse bilateral interstitial abnormality but when compared to a prior study dating ___ at 8:02, the degree of interstitial abnormality has substantially subsided, and therefore these findings are suggestive of resolving pulmonary and interstitial edema   Keywords: resolving. There is a persistent deformity of the right lower ribcage consistent with previous fractures. No large effusions. No evidence of pneumothorax.

SubjectID: 10194776, StudyID: 55971996, Comparison: same

FINAL REPORT

PORTABLE CHEST FILM ___ AT ___ CLINICAL

INDICATION: ___-year-old with new Dobbhoff tube placement, verify position. Comparison is made to the patient's previous studies dated ___ at 802. Two views of the chest obtained in the semi-erect position are submitted for interpretation.

IMPRESSION: 1. On the initial view, the Dobbhoff feeding tube appears to be coiled just above the gastroesophageal junction. On the second projection, the tube now traverses below the diaphragm with the tip coiled within the stomach. Dual-lead left-sided pacer remains in place. The heart remains stably enlarged. There continues to be a bilateral interstitial and parenchymal process which is not significantly changed and may reflect pulmonary edema, although underlying interstitial lung disease should also be considered   Keywords: not significantly changed. There are likely small layering effusions. No pneumothorax.

SubjectID: 10213338, StudyID: 59947457, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman intubated s/p resuscitation c/f volume ovelroad // interval change

IMPRESSION: In comparison to previous radiograph of 1 day earlier, endotracheal tube now terminates 2 cm above the carinal with the neck in a flexed position. There is otherwise no relevant change in the appearance of the chest since recent study   Keywords: no relevant change.

SubjectID: 10213338, StudyID: 59104846, Comparison: None

FINAL REPORT

EXAMINATION: CHEST RADIOGRAPH

INDICATION: ___ year old woman now intubated s/p exlap // confirm ETT position

TECHNIQUE: AP VIEW OF THE CHEST

COMPARISON: CHEST RADIOGRAPHS FROM ___

FINDINGS: An endotracheal tube terminates just above the carina and should be pulled back 3-4 cm for ideal positioning. A right internal jugular catheter terminates in the mid SVC. An enteric tube descends below the field of view, likely within the stomach. There is a persistent left basal opacity which suggests consolidation or atelectasis, minimally increased from the prior examination. There is minimal right basal atelectasis. There is no large effusion or pneumothorax.

IMPRESSION: Endotracheal tube should be pulled back 3-4 cm for ideal positioning, as it not terminates just above the carina. Dense retrocardiac opacity could reflect atelectasis or consolidation.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on ___ at 1:31 PM, 5 minutes after discovery of the findings.

SubjectID: 10213338, StudyID: 54542962, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with ESRD - extuabted // interval change interval change

IMPRESSION: In comparison with the study of ___, the endotracheal tube has been removed. Continued enlargement of the cardiac silhouette with evidence of elevated pulmonary venous pressure. Retrocardiac opacification again is consistent with substantial volume loss in the left lower lobe, probably associated with some pleural fluid. Other monitoring and support devices are unchanged.

SubjectID: 10213338, StudyID: 52546580, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___ year old woman NGT placement // NGT placement

TECHNIQUE: AP view of the chest

COMPARISON: Multiple prior radiographs from ___

FINDINGS: An endotracheal tube terminates 9 mm above the carina. A right internal jugular catheter terminates in the mid SVC as before. An enteric tube terminates within the stomach. A dense retrocardiac opacity persists which could reflect atelectasis or consolidation.

IMPRESSION: Endotracheal tube terminates 9 mm above the carina. Dense retrocardiac opacity persists.

SubjectID: 10213338, StudyID: 53276473, Comparison: same

FINAL REPORT

INDICATION: History of end-stage renal disease who spiked a fever, please evaluate for pneumonia.

COMPARISON: Multiple chest radiographs dating back to at least ___.

TECHNIQUE: Single portable exam of the chest.

FINDINGS: The heart size is moderately enlarged, overall stable compared to the prior exams. There is mild pulmonary vascular congestion with cephalization of the vessels and bilateral hilar fullness, without evidence of definite pulmonary edema. There is a new focal consolidation overlying the right lower lobe compared to the prior exam. There is increased left lung base atelectasis. No large pleural effusions are identified. There is no evidence of a pneumothorax.

IMPRESSION: 1. New focal consolidation overlying the right lower lobe concerning for pneumonia. 2. Stable cardiomegaly with cephalization of the vessels and hilar fullness, without evidence of pulmonary edema   Keywords: stable.

SubjectID: 10213338, StudyID: 56429409, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: (E) ___F SLE, ESRD on HD s/p failed LRRT (___) s/p ACS/DESx2 p/w mesent ischemia s/p R colectomy/open abd, washout, primary anst, closure, s/p rxn leaking anastomosis, end ileostomy with R CVL ? pulled back // assess location of R CVL (? pulled back) assess location of R CVL (? pulled back)

IMPRESSION: Comparison to ___. No relevant change   Keywords: no relevant change. Both monitoring and support devices are in stable position. No pneumothorax or other complications. Minimally increasing retrocardiac atelectasis. Otherwise unchanged radiograph   Keywords: unchanged radiograph.

SubjectID: 10213338, StudyID: 55352955, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with vomiting this morning, and tape connection off tubing on assessment // Assess placement of the feeding tube Assess placement of the feeding tube

IMPRESSION: In comparison with the study of ___, there is continued opacification at the left base silhouetting the hemidiaphragm, consistent with volume loss in the left lower lobe and pleural effusion. No convincing evidence of new consolidation. The view of the abdomen shows the tip of the Dobhoff tube in the distal stomach. Right IJ catheter extends to the mid to lower portion of the SVC.

SubjectID: 10213338, StudyID: 52735997, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with newly placed DHT // DHT placement

IMPRESSION: Radiographs performed for assessment of a Dobhoff tube placement demonstrates tip of tube terminating in the region of the gastroduodenal junction. A comparison the ___ chest radiograph, cardiomegaly and increased pulmonary vascularity persist. Small bilateral pleural effusions are new, accompanied by bibasilar atelectasis.

SubjectID: 10213338, StudyID: 54755986, Comparison: same

WET READ: ___ ___ 9:48 PM No substantial change from prior. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with hemoptysis, new fever. History of mitral regurgitation. Evaluate for infection

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: ___. And dating back to ___.

FINDINGS: Pulmonary vascular congestion is not significantly changed   Keywords: not significantly changed. Marked cardiomegaly is unchanged. There is no pneumothorax. Mediastinal contours are stable.

IMPRESSION: No significant interval change   Keywords: no significant interval change.

SubjectID: 10213338, StudyID: 51156376, Comparison: None

FINAL REPORT

TECHNIQUE: Portable frontal radiograph of the chest from ___.

INDICATION: ___ year old woman with hemoptysis // Evaluate for infection, hemorrhage. ___ year old woman with hemoptysis. Evaluate for infection, hemorrhage.

COMPARISON: ___. Correlation made to chest CT dated ___.

FINDINGS: Stable enlargement of the cardiac silhouette accompanied by pulmonary vascular congestion superimposed upon chronic upper zone vascular redistribution in this patient with history of mitral regurgitation. Continued improvement and nonspecific left retrocardiac opacity, with no new foci of consolidation to suggest a note new source of infection.

SubjectID: 10213338, StudyID: 51096943, Comparison: None

FINAL REPORT

INDICATION: History: ___F with fever, cough // CXR: eval for pna

TECHNIQUE: Chest PA and lateral

COMPARISON: ___

FINDINGS: The patient is slightly rotated. Allowing for this, the heart is not enlarged. The aorta is calcified, but the cardiomediastinal contours are otherwise within normal limits. Calcified coronary arteries are noted. Rounded density at the right lung base and at the periphery of the left base is thought to represent nipple shadows. Crowding of vessels noted in the right base inferiorly. No increased interstitial markings seen in this area on the ___ radiographs. There is artifact overlying posterior chest on the lateral view. While a focal infiltrate there cannot be excluded, there are no corroborating findings on the AP view. Otherwise, no focal consolidation, pleural effusion or pneumothorax. Chain sutures are noted at the right lung apex for which clinical correlation is requested. Focal vascular calcifications are seen in the left upper arm. Density of the bilateral humeral heads may reflect bone infarcts.

IMPRESSION: Limited assessment of the posterior chest due to overlying artifact. Allowing for this, no pneumonia identified. If clinically indicated, a repeat lateral view could be attempted at no additional charge to the patient. Mild prominence of vessels at the right lung base medially is thought to represent artifact due to rotation. Differential includes atelectasis and bronchiectasis. The appearance is less pronounced than on radiographs from ___ and ___. Chain sutures noted at the right lung apex, compatible with prior surgery. Aortic and coronary artery calcification noted. Vascular calcifications also seen adjacent to the distal humerus. Suspected bilateral humeral head osteonecrosis.

NOTIFICATION: Dilatation persisting a posterior chest due to artifact was emailed to EDQ a nurse's uncovering clinician's at 22:59 on ___.

SubjectID: 10213338, StudyID: 50988974, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with complicated PMHx presents with fever // please assess lateral view for abnormality please assess lateral view for abnormality

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Mild hyperexpansion of the lungs again is seen with the cardiac silhouette at the upper limits of normal in size. No vascular congestion or acute focal pneumonia or pleural effusion.

SubjectID: 10216097, StudyID: 58231661, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF exacerbation, hemothorax, pneumo, s/p RHC/LHC, still dyspnic. // please eval evolution of effusion, edema, pneumo please eval evolution of effusion, edema, pneumo

IMPRESSION: In comparison with the study of ___, there is little change   Keywords: little change. Again there is substantial enlargement of the cardiac silhouette with some elevation of pulmonary venous pressure in prominence of the mediastinum. Probable loculated pleural fluid is again seen in the right mid zone.

SubjectID: 10216097, StudyID: 52360092, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with recent VATS for hemothorax now with new hemoptysis. // Is there a new process in the lung?

IMPRESSION: As compared to ___, a small right apical pneumothorax is similar to prior study. Hazy increased opacity with oblique orientation A in the right mid lung probably represents loculated pleural fluid. New patchy right retrocardiac opacity could reflect atelectasis, aspiration, and less likely developing pneumonia. Short-term followup radiographs may be helpful in this regard.

SubjectID: 10216097, StudyID: 51841478, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p VATS decortication, s/p DC of basilar drain. Please perform around noon. // Post pull evaluation

COMPARISON: CHEST X-RAY FROM ___ AT 07:32.

FINDINGS: THE DRAIN PREVIOUSLY SEEN AT THE BASE OF THE LEFT LUNG IS NOT DEFINITIVELY IDENTIFIED. POSSIBLE SMALL RIGHT APICAL PNEUMOTHORAX. SMALL RIGHT EFFUSION AND HAZY OPACITY ALONG THE LOWER RIGHT CHEST IS NOT SIGNIFICANTLY CHANGED. THE PREVIOUSLY SEEN ELLIPSOID DENSITY IN THE RIGHT MIDZONE IS NO LONGER VISUALIZED. MINIMAL PLATELIKE ATELECTASIS OR TRACE FLUID IN THE MINOR FISSURE IS NOW NOTED. OTHERWISE, I DOUBT SIGNIFICANT INTERVAL CHANGE.

IMPRESSION: INTERVAL REMOVAL OF DRAIN. SUSPECT SMALL RIGHT APICAL PNEUMOTHORAX.

SubjectID: 10216097, StudyID: 50944321, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hemothorax s/p chest tube X 3 // please eval for interval change in hemothorax please eval for interval change in hemothorax

IMPRESSION: In comparison with the study of ___, there again is substantial enlargement of the cardiac silhouette with apparent loculated pleural fluid in the right mid zone. Mild elevation of pulmonary venous pressure is again seen. Asymmetric opacification at the right base raises the possibility of atelectasis, aspiration, or even pneumonia. Prominence of interstitial markings is consistent with some elevation of pulmonary venous pressure.

SubjectID: 10216097, StudyID: 58218519, Comparison: None

WET READ: ___ ___ ___ 7:36 AM Significant increase in large right pleural effusion with leftwards shift of mediastinum. No left pleural effusion. No evidence of pulmonary edema. Limited evaluation of the heart due to overlying abnormality. ___ D/w Dr. ___ ___ at 12:50 AM at time of discovery.

WET READ VERSION #1 ___ ___ ___:55 AM Interval increase in large right pleural effusion with leftwards shift of mediastinum. No left pleural effusion. No evidence of pulmonary edema. Limited evaluation of the heart due to overlying abnormality. ___ D/w Dr. ___ ___ at 12:50 AM at time of discovery. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with recent chest tubes. // Is there an acute process in the lungs?

TECHNIQUE: CHEST (PA AND LAT)

COMPARISON: ___

IMPRESSION: There is substantial interval increase in right pleural effusion with the leftward shift of the mediastinum. No substantial left pleural effusion demonstrated. No definitive pulmonary edema is seen. No pneumothorax is present.

NOTIFICATION: ___ D/w Dr. ___ ___ at 12:50 AM at time of discovery.

SubjectID: 10216097, StudyID: 56756725, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with R hemothorax s/p VATS and thoracentesis with 3 chest tubes in place // Eval for interval change

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: 3 right chest tubes are in place. There is questionable minimal apical pneumothorax on the right. There is also fluid within the major fissure. Cardiomediastinal silhouette is unchanged as well as there is no change in bibasal atelectasis.

SubjectID: 10216097, StudyID: 53279592, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with sCHF, R pleural effusion s/p chest tube placement and removal on ___ // Interval change

IMPRESSION: As compared to ___, right pleural catheter has been removed, with slight increase in size of a moderate right pleural effusion but no definite pneumothorax. Persistent enlarged cardiac silhouette accompanied by pulmonary vascular congestion and worsening edema   Keywords: worse.

SubjectID: 10216097, StudyID: 52134581, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with R pleural effusion concern for hemothorax s/p insertion of ___F catheter given supsected hemothorax. // eval R chest tube eval R chest tube

IMPRESSION: In comparison with the earlier study of this date, a right chest catheter is in place and there has been removal of a substantial amount of pleural fluid on the right. Nevertheless, the large effusion persists. No evidence of pneumothorax. The left lung remains clear and there is no evidence of pulmonary vascular congestion.

SubjectID: 10216097, StudyID: 51982352, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hemothorax s/p evacuation // eval post op change eval post op change

IMPRESSION: In comparison with the earlier study of this date, there now are 2 chest tubes in place on the right following drainage of the substantial hemothorax there is increase in size of the cardiac silhouette with indistinctness of pulmonary vessels consistent with some elevated pulmonary venous pressure   Keywords: increase. Left basilar opacification suggests small layering effusion with compressive atelectasis in the left lower lung. .

SubjectID: 10216097, StudyID: 57102728, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p CT DC. Please perform around 1230PM // Evaluation of post pull PTX

COMPARISON: Chest x-ray from ___ at 839

FINDINGS: The right-sided chest tube is been removed. There is a tiny right apical pneumothorax and possible tiny loculated pneumothorax at the base of the right lung. Otherwise, I doubt significant interval change. Minimal blunting of the right costophrenic angle is again noted.

IMPRESSION: As above..

SubjectID: 10216097, StudyID: 56442522, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p VATS decortication with basilar ___ drain. Please perform ___ AM // Routine evaluation for PTX

COMPARISON: Chest x-ray from ___ at 12:25

FINDINGS: Again seen is the drain along the base of the right lung. There is minimal atelectasis. Equivocal trace pneumothorax at the right lung apex. Previously seen lucency at right lung base is no longer visualized. New on today's exam, there is an ellipsoid opacity in the right mid zone. This is partly accounted for by the overlying scapular angle. Doubt pneumonic consolidation. Bibasilar atelectasis is slightly increased. Upper zone redistribution is also slightly more pronounced. No gross left effusion. The cardiomediastinal silhouette is enlarged, but unchanged.

IMPRESSION: 1. Right lung base drain remains in place. Minimal , if any, residual pneumothorax. 2. Upper zone redistribution bibasilar atelectasis slightly increased. No overt CHF. 3. Ovoid opacity right mid lung -- question artifact due to overlying scapula. Attention to this area on followup films is requested.

SubjectID: 10216097, StudyID: 56235879, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with pleural effusion s/p drain placement. // Is there interval change?

COMPARISON: ___

FINDINGS: Again seen is a right chest tube, with opacity and pleural fluid/ thickening at the right base. There has been slight improvement compared with 1 day earlier. Otherwise, I doubt significant interval change. No pneumothorax detected.

IMPRESSION: Slight interval improvement in opacities at right base.

SubjectID: 10216097, StudyID: 55079536, Comparison: worse

FINAL REPORT

INDICATION: Hemothorax with multiple chest tubes. Evaluate for change.

TECHNIQUE: Single upright AP view of the chest.

COMPARISON: Multiple chest radiographs, including the most recent from ___.

FINDINGS: Three chest tubes are unchanged in position. No definite pneumothorax is identified. There has been improved aeration at the right base, likely due to improved atelectasis. A small amount of right pleural fluid remains, though has decreased since the prior exam. Subcutaneous air along the right chest wall is likely from the recent chest tube insertions. There is mild left basilar atelectasis and a tiny left pleural effusion. Since the prior exam, vascular congestion has slightly worsened   Keywords: worse. There is no evidence of pneumonia. No left pneumothorax is identified. The mediastinal contours are normal. The cardiac silhouette is significantly enlarged, and unchanged.

IMPRESSION: 1. Improved aeration at the right base, likely due to decreased atelectasis and a slightly decrease in the amount of residual pleural fluid. 2. Slight interval worsening of mild vascular congestion   Keywords: worse. 3. Enlarged cardiac silhouette, which is presumably due to cardiomegaly, though a pericardial effusion cannot be completely excluded.

SubjectID: 10216097, StudyID: 54687008, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with right pleural effusion s/p VATS evacuation and 3x chest tubes. Anterior chest tube now removed. // Eval post chest tube removal. ***Please perform exam at ___ today*** Eval post chest tube removal. ***Please perform exam at ___

IMPRESSION: In comparison with the earlier study of this date, the anterior chest tube has been removed. No evidence of pneumothorax. Increasing opacification at the right base is consistent with effusion and atelectasis, though in the appropriate clinical setting superimposed pneumonia would have to be considered. Substantial enlargement of the cardiac silhouette process.

SubjectID: 10216097, StudyID: 54747485, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heart failure, mediastinal mass // Please eval PA line position, volume status Please eval PA line position, volume status

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. The tip of the Swan-___ catheter again extends into the right pulmonary artery beyond the mediastinal border. Loculated pleural effusion within the major fissure on the right is essentially unchanged. Moderate enlargement of the cardiac silhouette is again seen with mild indistinctness of pulmonary vessels suggesting some elevated pulmonary venous pressure   Keywords: again. Blunting of the right costophrenic angle is again noted.

SubjectID: 10216097, StudyID: 54115167, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with heart failure with PA catheter in place // eval PA catheter placement eval PA catheter placement

IMPRESSION: In comparison with the earlier study of this date, the PA catheter is been pulled back to a good position within the mediastinal portion of the right pulmonary artery. Otherwise little change   Keywords: little change.

SubjectID: 10216097, StudyID: 52212875, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF now with tailored therapy // eval PA catheter placement eval PA catheter placement

IMPRESSION: In comparison with the study of ___, there is little overall change   Keywords: little overall change. Continued substantial enlargement of the cardiac silhouette with mild elevation of pulmonary venous pressure and pseudo tumor of pleural fluid in the major fissure on the right. Swan-Ganz catheter remains in good position.

SubjectID: 10216097, StudyID: 54394310, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with sob // ? chf

COMPARISON: None

FINDINGS: PA and lateral views of the chest provided. Opacity involving the right mid through lower lung is concerning for pneumonia with associated small effusion. Left lung appears grossly clear. The heart size cannot be assessed. No pneumothorax. Bony structures are intact.

IMPRESSION: Right mid to lower lung opacity concerning for right middle and lower lobe pneumonia with associated right pleural effusion. Recommend followup to resolution.

SubjectID: 10216097, StudyID: 50082130, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with large right pleural effusion s/p ___fr pigtail placement // ? PTX ? PTX

IMPRESSION: In comparison with the study of ___, there has been placement of a pigtail catheter at the right base with removal of some of pleural fluid. No evidence of pneumothorax. Some residual opacification is consistent with pleural fluid and volume loss in the lower lungs. Cardiac silhouette is prominent and there is some indistinctness of pulmonary vessels suggesting some underlying vascular congestion.

SubjectID: 10220107, StudyID: 59382620, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with shortness of breath // Please evaluate pleural effusion

COMPARISON: Radiographs from ___.

IMPRESSION: There is cardiomegaly which is stable. There is a small to moderate size left pleural effusion which is stable. Atelectasis at the left mid to lower lung field is again seen. Overall, findings are stable. There are no pneumothoraces.

SubjectID: 10220107, StudyID: 51305147, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with chf and B pleural effusions s/p R ___. // ptx

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Left pleural effusion is small to moderate, unchanged. Left basal atelectasis is unchanged. No new consolidations demonstrated. After right thoracocentesis there is no evidence of pneumothorax. And no appreciable right pleural effusion is currently seen

SubjectID: 10220107, StudyID: 54172281, Comparison: None

WET READ: ___ ___ 7:15 PM Status post left chest tube removal with no large pneumothorax; however, a small left apical pneumothorax cannot be excluded. Otherwise, little change compared to prior study from the same day. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post chest tube removal, evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the left chest tube has been removed. There is currently no evidence of left pneumothorax. A previously placed mediastinal drain has also been removed. The right central introduction sheath persists. Moderate cardiomegaly without pulmonary edema. Hiatal hernia.

SubjectID: 10220107, StudyID: 51804485, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with CABG, dropping of hematocrit, evaluation for effusion.

COMPARISON: Multiple chest x-rays from ___ to ___.

FINDINGS: The patient has been extubated. Swan-Ganz has been removed. Remaining right jugular sheath is in lower jugular vein. There is no pneumothorax or pleural effusion. There is no pulmonary edema. Moderate cardiac contour enlargement is stable.

CONCLUSION: 1. The patient just had sternotomy for CABG. 2. There is no pneumothorax or pleural effusion. 3. Moderate cardiomegaly is unchanged.

SubjectID: 10245890, StudyID: 59928668, Comparison: same

FINAL REPORT

HISTORY: CHF exacerbation with subjective fever.

FINDINGS: In comparison with study of ___, there is little interval change   Keywords: little interval change. There is huge enlargement of the cardiac silhouette with minimal if any vascular congestion. This combination suggests cardiomyopathy or pericardial effusion. No acute focal pneumonia. The single-lead pacemaker extends to the apex of the right ventricle.

SubjectID: 10245890, StudyID: 53110670, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with shortness of breath and bilateral lower extremity edema, question pulmonary edema.

COMPARISONS: Multiple prior radiographs, most recently from ___.

FINDINGS: AP and lateral chest radiograph. No overt edema but mild interstitial edema is difficult to exclude. Severe cardiomegaly is unchanged. There are no pleural effusions or pneumothorax. Left chest wall pacemaker with lead in the right ventricle is unchanged. Bony structures are intact.

IMPRESSION: Stable marked cardiomegaly. No overt pulmonary edema but mild interstitial edema is difficult to exclude.

SubjectID: 10245890, StudyID: 58626162, Comparison: None

FINAL REPORT

INDICATION: ___M with 8 days of fevers, bibasilar crackles on physical examination. // Please evaluate for pneumonia .

COMPARISON: Multiple chest radiographs dating back to ___. Chest CTA ___.

TECHNIQUE Frontal and lateral views of the chest.

FINDINGS: Massive cardiomegaly is unchanged. A single lead pacemaker is seen in the right ventricle. Mediastinal and hilar contours are normal. There is no pulmonary edema. There is no focal consolidation to suggest pneumonia. Calcifications are noted within the aortic arch. There is no pneumothorax or large pleural effusion.

IMPRESSION: Unchanged massive cardiomegaly. No focal consolidation to suggest pneumonia.

SubjectID: 10245890, StudyID: 52493110, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with dCHF COPD A. fib on warfarin, MR and TR, on home O2 at home with SOB, chest tightness and crackles bilaterally ___ up // pulm edema?

COMPARISON: ___ chest radiograph and ___ CT.

IMPRESSION: Massive cardiomegaly is accompanied by pulmonary vascular congestion. Interval resolution of interstitial edema. Lungs are clear except for improving atelectasis in the left lung base. No definite pleural effusion or pneumothorax.

SubjectID: 10245890, StudyID: 57370787, Comparison: same

FINAL REPORT

INDICATION: Shortness of breath and chest pain.

COMPARISONS: ___ and ___.

FINDINGS: AP portable view of the chest demonstrates hyperexpanded lungs. Severe cardiomegaly is redemonstrated. Moderate pulmonary edema persists   Keywords: persists. No pleural effusions or pneumothorax. Aorta appears tortuous. Single AICD device lead projects over right ventricle.

IMPRESSION: Severe cardiomegaly and moderate pulmonary edema, essentially unchanged since ___ exam   Keywords: unchanged.

SubjectID: 10245890, StudyID: 51785820, Comparison: better

WET READ: ___ ___ ___ 7:03 PM Marked cardiomegaly as before with slight mprovement in mild to moderate pumonary edema.

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

AP CHEST, 4:04 P.M., ___

HISTORY: ___-year-old man with shortness of breath and chronic CHF exacerbation. Check for pulmonary edema.

IMPRESSION: AP chest compared to ___ at 6:01 a.m.: Previous mild pulmonary edema has improved, although the extent of pulmonary vascular congestion is slightly more pronounced today than it was on ___ indicating that cardiac function could further improve   Keywords: improve. Severe cardiomegaly is longstanding. Pleural effusions are minimal, if any. Transvenous right ventricular pacer lead in standard placement. No pneumothorax.

SubjectID: 10245890, StudyID: 54971648, Comparison: None

FINAL REPORT

INDICATION: Tachybrady syndrome, evaluation for CHF.

COMPARISON: ___ and ___.

FINDINGS: Upright AP radiograph demonstrates severe cardiomegaly, worsened from ___. There is redistribution of pulmonary vascularity to the upper zones but no evidence of overt pulmonary edema. There is no pneumothorax. Atherosclerotic calcifications are noted in the aortic arch. Splaying of the mainstem bronchi likely represents left atrial enlargement.

IMPRESSION: Severe cardiomegaly, worsened from ___.

SubjectID: 10245890, StudyID: 54776161, Comparison: None

FINAL REPORT

STUDY: PA and lateral chest. CLINICAL

HISTORY: ___-year-old man with new single chamber pacemaker. Evaluate lead position.

FINDINGS: Comparison is made to previous study from ___. There is a single-lead left-sided pacemaker with distal lead tip in the right ventricle. There is markedly enlarged cardiomegaly. This is stable. The visualized lung fields are grossly clear; however, they are somewhat hyperexpanded, suggestive of emphysema. There are degenerative changes and mild wedge compression deformities of several thoracic vertebral bodies.

SubjectID: 10246786, StudyID: 57071923, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH.

INDICATION: Hypoxia, large volume thoracocentesis. Questionable pneumothorax. Evaluation.

FINDINGS: As compared to the previous radiograph, there is ongoing increasing opacification of the right lower lung, associated to air bronchograms. The findings are highly suggestive of either pneumonia or aspiration. There is no evidence of pneumothorax. The left hemithorax is unremarkable. Borderline size of the cardiac silhouette without pulmonary edema. At the time of dictation and observation, 9:54 a.m., on ___, the referring physician, ___. ___, was paged for notification and the findings were discussed over the telephone one minute later. The pigtail catheter on the right is in unchanged position. There is no major pleural effusion.

SubjectID: 10246786, StudyID: 55919768, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Large recurrent right effusion, status post pigtail placement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a small right Pleurx catheter. The extent of the pre-existing right pleural effusion has decreased. Also decreased are the areas of pre-existing atelectasis at the right lung base. However, the moderate amount of right effusion remains. There is no evidence for right pneumothorax. Moderate cardiomegaly of unchanged. No change in appearance of the left lung   Keywords: no change.

SubjectID: 10246786, StudyID: 53823571, Comparison: None

WET READ: ___ ___ ___ 8:25 PM There is little overall change from the prior radiograph in terms of the right lower lobe opacities concerning for pneumonia versus aspiration. There may be developing left lower lobe opacities now as well. ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is a minimal decrease in extent and severity of the pre-existing right lower lobe opacities that, however, still remain visible and are concerning for pneumonia or aspiration. Mild atelectasis in the retrocardiac lung regions. Mild fluid overload but no overt pulmonary edema. Unchanged low lung volumes and mild cardiomegaly.

SubjectID: 10246786, StudyID: 51178547, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post drainage.

FINDINGS: As compared to the previous radiograph, the right pigtail catheter in the pleural space is of unchanged position. The pleural effusion has substantially decreased. No pneumothorax. No other relevant change   Keywords: no other relevant change.

SubjectID: 10246786, StudyID: 50180753, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Status post thoracocentesis.

COMPARISON: ___, 2:44 a.m.

FINDINGS: As compared to the previous radiograph, the right plaural pigtail catheter is in unchanged position. There has been minimal re-accumulation of pleural fluid. Mild atelectasis at the right lung bases. Unchanged appearance of the cardiac silhouette. Unchanged normal appearance of the left lung.

SubjectID: 10246786, StudyID: 56299661, Comparison: None

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Fever, chills and cough.

COMPARISON: Multiple priors dating back to ___ and most recent from ___.

FINDINGS: There has been significant interval increase in opacity projecting over the right lower hemithorax worrisome for pleural effusion and consolidation. Underlying atelectasis. Additional focus of opacity projecting over the level of the posterior lateral right sixth rib may be concerning for additional site of consolidation. The left lung is grossly clear. There is no left pleural effusion. The right heart border is not well assessed due to the right lower hemithorax opacification. Aortic knob calcification is seen. Evidence of DISH is seen along the spine.

IMPRESSION: Large area of opacity projecting over the right lower hemithorax is worrisome for consolidation and pleural effusion. Additional small focus of opacity superior to this concerning for additional site of infection.

SubjectID: 10246786, StudyID: 56260004, Comparison: None

FINAL REPORT

HISTORY: Status post thoracentesis.

COMPARISON: Chest radiograph ___, ___.

FINDINGS: AP and lateral views the chest were viewed. The cardiomediastinal and hilar contours are stable. There has been decrease in the right pleural effusion following thoracentesis. No pneumothorax is seen. A left PICC line is present in the left brachiocephalic vein, but the tip is not well visualized.

SubjectID: 10246786, StudyID: 52475019, Comparison: None

FINAL REPORT

EXAMINATION: PA and lateral chest

INDICATION: History: ___M with missed dialysis // evel for chf

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___ at ___.

FINDINGS: Moderate cardiomegaly appears slightly increased in size compared to the prior exam from ___ which may reflect cardiomegaly, although pericardial effusion should also be considered. Moderate right-sided pleural effusion, also has increased compared to the prior exam. There has been interval appearance of mild pulmonary edema. There may be a small left pleural effusion. Retrocardiac opacity is likely secondary to atelectasis, although pneumonia cannot be entirely excluded. There is no evidence of pneumothorax. The visualized osseous structures are unremarkable.

IMPRESSION: 1. Mild pulmonary edema. Increasing right pleural effusion.

SubjectID: 10246786, StudyID: 50348492, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with R sided pleural effusion // ? interval change in pleural effusion

COMPARISON: ___.

FINDINGS: Moderate right pleural effusion. It has apparently decreased in size since the recent radiograph, but positional differences in made contribute to this apparent change. Cardiomediastinal contours are normal. Left lung and pleural surfaces are clear

SubjectID: 10251182, StudyID: 59453442, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with worsening dyspnea.

COMPARISON: Comparison is made with chest radiograph from ___ and ___.

FINDINGS: The lungs are well expanded. There is interval development of asymmetric mild pulmonary edema, right greater than left   Keywords: development. Alternatively, this could be a symmetric pulmonary edema with a right lower lobe pneumonia, but this is less likely. There is no pneumothorax or pleural effusion. Cardiomediastinal silhouette is unremarkable.

IMPRESSION: Acute asymmetric pulmonary edema, right greater than left, more likely than mild edema and concurrent right pneumonia.

SubjectID: 10251182, StudyID: 54716931, Comparison: better

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with history of gastrostomy, CAD, CABG, CCU pulmonary edema, OG tube position.

COMPARISON: ___.

FINDINGS: NG tube is in adequate position in the stomach. ET tube ends 3.6 cm above the carina. Pulmonary edema has improved and is now minimal   Keywords: improve. Bilateral mild-to-moderate pleural effusion is new with bibasilar atelectasis. Superimposed infection cannot be excluded in appropriate clinical setting.

SubjectID: 10251182, StudyID: 54141224, Comparison: None

FINAL REPORT

HISTORY: ___-year-old man with fever.

COMPARISON: ___.

TECHNIQUE: PA and lateral views of the chest.

FINDINGS: Lung volumes are low. Retro-cardiac opacity likely represents atelectasis, although infectious process can be considered. Cardiomediastinal silhouette is mildly enlarged. Patient is status post median sternotomy. No pleural effusion or pneumothorax is identified.

SubjectID: 10251182, StudyID: 53163573, Comparison: better

FINAL REPORT

INDICATION: ___-year-old male with STEMI and pulmonary edema.

COMPARISON: Comparison is made with chest radiograph from ___ and ___.

FINDINGS: Two frontal images of the chest demonstrate low lung volumes likely due to poor inspiration. Vascular crowding and minimal pulmonary edmea has resolved from previous exam. Left basilar atelectasis has improved. Bilateral pleural effusions are again seen. Cardiomediastinal silhouette is unchanged. There is no pneumothorax. Support and maintenance devices are unchanged.

IMPRESSION: Resolved pulmonary edema   Keywords: resolve. Improving left basilar atelectasis. Bilateral small pleural effusions.

SubjectID: 10251182, StudyID: 53849979, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with cord compression // ETT placement

TECHNIQUE: Portable chest

COMPARISON: ___

FINDINGS: THE ENDOTRACHEAL TUBE IS 4 CM ABOVE THE CARINA. LUNG VOLUMES ARE LOW WITH COMPRESSIVE CHANGES AT THE BASES. THERE IS A SMALL LEFT EFFUSION. HEART SIZE IS UPPER LIMITS NORMAL

IMPRESSION: NO significant change   Keywords: no significant change

SubjectID: 10251182, StudyID: 53387478, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p lumbar spine surgery, intubated, new OGT placed // line placement

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: ET tube is 4.5 cm above the Carina. NG tube tip is in the stomach. Hardware projects over the lumbar spine with associated skin ___. Sternal wires are again visualized. Lung volumes are low and there is volume loss at the bases. There is a more focal area of opacity obscuring the left CP angle that could be volume loss/ infiltrate/effusion

IMPRESSION: Left lower lobe volume loss/ infiltrate/effusion

SubjectID: 10251182, StudyID: 52434441, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with spinal cord compreswsion, NGT in place // evaluate NGT placement

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change. The NG tube tip is in the stomach

SubjectID: 10253057, StudyID: 57284535, Comparison: better

FINAL REPORT

INDICATION: Pulmonary edema identified on ___. Evaluation for resolution.

COMPARISON: ___.

FINDINGS: PA and lateral chest radiographs demonstrate marked improvement of pulmonary edema with asymmetric residual opacities in the left perihilar region   Keywords: improve. There are persistent bilateral pleural effusions, moderate on the left and mild on the right as well as associated left lower lobe atelectasis. Median sternotomy wires and CABG clips are noted. The heart size is normal. There is no pneumothorax.

IMPRESSION: Marked improvement in pulmonary edema with residual left perihilar opacities   Keywords: improve.

SubjectID: 10253057, StudyID: 57249850, Comparison: worse

FINAL REPORT

STUDY: PA and lateral chest, ___. CLINICAL

HISTORY: ___-year-old man with end-stage renal disease. Patient admitted for hypoxia and dyspnea.

FINDINGS: Cardiac silhouette is enlarged. There is a left retrocardiac opacity and left-sided pleural effusion, which have increased since the prior study. There are also increased areas of consolidation in the left upper lobe. These may represent asymmetric edema versus developing pneumonia   Keywords: developing. The right lung is relatively clear.

SubjectID: 10253057, StudyID: 56046519, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with hypoxia.

COMPARISON: ___.

FINDINGS: A single portable AP chest radiograph was obtained. There is a large left and small-to-moderate right pleural effusion. There is diffuse bilateral hilar interstitial opacity. An asymmetric opacity is seen in the central left upper lobe. Median sternotomy wires, mediastinal clips and right lung chain suture are stable.

IMPRESSION: 1. Large left and moderate right effusions and pulmonary vascular congestion suggest moderate-to-severe pulmonary edema. 2. Asymmetric opacity in the central left upper lobe has somewhat of a "butterfly" appearance of pulmonary edema. However, given the unilateral distribution, the presence of an additional consolidation or mass is likely. Repeat radiographs should be taken after diuresis. Cross sectional imaging may be considered at that point if the diagnosis remains in doubt.

SubjectID: 10253057, StudyID: 55142680, Comparison: None

FINAL REPORT

HISTORY: ___-year-old male status post amputation. Evaluate for pulmonary edema.

COMPARISON: Multiple prior radiographs of the chest dated ___ through ___.

FINDINGS: Portable semi-upright radiograph of the chest demonstrates low lung volumes with resulting bronchovascular crowding. There is persistent increased opacification at the left base, likely secondary to pleural effusion with adjacent atelectasis; however, superimposed infection cannot be excluded. There is evidence of mild to moderate pulmonary edema. There is no pneumothorax. There is pneumoperitoneum present with air below the right hemidiaphragm.

IMPRESSION: 1. There is pneumoperitoneum present with air below the right hemidiaphragm. 2. Small left-sided pleural effusion with adjacent atelectasis. 3. Mild-moderate pulmonary edema. COMMENTS: Impression #1 was discussed with Dr. ___ ___ by Dr. ___ ___ telephone at 4:___pm on ___, 1.5 hours after discovery.

SubjectID: 10253057, StudyID: 54981721, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Tachycardia, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the lung volumes have decreased and the size of the cardiac silhouette has increased. There might be mild fluid overload, but no overt pulmonary edema is present. Small newly appeared left pleural effusion with subsequent atelectasis in the retrocardiac lung regions.

SubjectID: 10259898, StudyID: 58549049, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with respiratory failure with CVL pulled back 3 cm // interval change of CVL position

COMPARISON: ___, 08:56

IMPRESSION: As compared to the previous radiograph, the pre-existing pulmonary edema has almost completely resolved   Keywords: resolve. Moderate cardiomegaly persists. The monitoring and support devices are constant. No larger pleural effusions. No pneumonia. No pneumothorax.

SubjectID: 10259898, StudyID: 53879792, Comparison: None

FINAL REPORT

INDICATION: ET tube, evaluate for tube placement.

TECHNIQUE: Portable supine chest radiograph was obtained.

COMPARISON: None available.

FINDINGS: The endotracheal tube terminates 3 cm above the carina. An enteric tube courses out of the field of view of this exam. A left chest AICD device has leads terminating in the right atrium, right ventricle, and coronary sinus. There is moderate pulmonary edema. The heart is moderately enlarged. There is no pneumothorax. Surgical clips are seen in the upper abdomen. Calcifications of the aortic arch and tracheobronchial tree are present.

IMPRESSION: 1. Endotracheal tube terminating 3 cm above the carina in appropriate position. 2. Moderate cardiomegaly and pulmonary edema.

SubjectID: 10259898, StudyID: 51944967, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with resp failure; evaluate for interval change

TECHNIQUE: Portable AP radiograph of the chest from ___.

COMPARISON: ___.

FINDINGS: The endotracheal tube remains at the carina, and should be withdrawn by 2-3 cm for more optimal positioning within the lower trachea. A left pectoral AICD remains in place. Other support devices including a right IJ central venous catheter and nasogastric tube remain in satisfactory position. There is no pneumothorax. The lungs are clear. Moderate cardiomegaly is stable. Metallic right upper quadrant surgical clips denote prior cholecystectomy.

IMPRESSION: Low-lying ET tube should be withdrawn by 2-3 cm for more optimal positioning within the lower trachea. Clear lungs. Stable moderate cardiomegaly.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 10:17 AM, 3 minutes after discovery of the findings.

SubjectID: 10277119, StudyID: 57465846, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman h/o renal transplant immunosuppressed s/p hernia repair // ?pna vs fluid overload

FINDINGS: Heart is upper limits of normal in size accompanied by pulmonary vascular congestion without overt pulmonary edema. Worsening left retrocardiac opacity could reflect atelectasis or developing pneumonia. . Note is also made of a small left pleural effusion.

COMPARISON: ___.

SubjectID: 10277119, StudyID: 53362710, Comparison: None

WET READ: ___ ___ ___:___ AM No evidence of pulmonary edema. A wire projects over the chest, which is likely external to the patient, however this cannot be confirmed in the absence of a lateral exam. Recommend removing external wires from the patient and a repeat examination with a frontal and lateral radiograph, for further evaluation. ___ were d/w Dr. ___ by Dr. ___ by phone at ___:___A on the day of the exam.

WET READ VERSION #1 ___ ___:___ AM No evidence of pulmonary edema. A wire projects over the chest, which is likely external to the patient, however this cannot be confirmed in the absence of a lateral exam. Recommend removing external wires from the patient and a repeat examination with a frontal and lateral radiograph, for further evaluation. ___ were d/w Dr. ___ by Dr. ___ by phone at ___:___A on the day of the exam. ______________________________________________________________________________

FINAL REPORT

INDICATION: ___ year old woman with renal transplant s/p incisional hernia repair // fluid status

COMPARISON: ___

FINDINGS: Cardiomegaly is accompanied by pulmonary vascular congestion, but no overt pulmonary edema. Patchy left retrocardiac opacity is likely atelectasis, but differential diagnosis includes aspiration and early infectious pneumonia. Short-term followup radiographs may be helpful in this regard.

SubjectID: 10277901, StudyID: 59248287, Comparison: same

FINAL REPORT

CLINICAL

HISTORY: CHF, COPD, acutely hypoxic. CHEST:

COMPARISON FILM: ___. There has been no significant change in the appearances since the two prior chest x-rays. Opacifications in both lungs probably due to failure are still present and essentially unchanged.

IMPRESSION: No change   Keywords: no change.

SubjectID: 10277901, StudyID: 58655581, Comparison: same

FINAL REPORT

CLINICAL

HISTORY: CHF and COPD, now with new productive cough. CHEST AP There has been no significant change since the prior chest x-ray of 15 hours previously. Increased opacifications are present in both lungs and bilateral effusions are present. Appearances are consistent with known failure, though additional infective process is not excluded.

IMPRESSION: No significant change   Keywords: no significant change. Failure persists.

SubjectID: 10277901, StudyID: 56002625, Comparison: same

FINAL REPORT

INDICATION: ___-year-old male with hypoxic respiratory failure, now requiring assessment of the re-positioned Dobbhoff tube.

COMPARISON: Comparison is made with chest radiograph from ___ and ___.

FINDINGS: Two frontal images of the chest demonstrate a Dobbhoff tube which has been advanced further into the stomach since previous imaging earlier the same day. There is no pneumothorax or other complication seen. There is no interval change in the pulmonary findings or cardiac findings   Keywords: no interval change.

IMPRESSION: Dobbhoff tube with tip in improved position within the stomach from prior exam. Otherwise unchanged chest radiograph.

SubjectID: 10277901, StudyID: 55312440, Comparison: better

FINAL REPORT

INDICATION: ___-year-old male with hypoxic respiratory failure secondary to CHF exacerbation requiring assessment of Dobbhoff tube placement.

COMPARISON: Comparison is made with chest radiographs from ___.

FINDINGS: Two frontal images of the chest demonstrate a Dobbhoff tube with the tip located within the proximal stomach. The tube should be advanced several centimeters more to put the tip more fully with the stomach. There is mild improvement in the pulmonary perivascular haze noted on previous exam   Keywords: improve. Otherwise, the chest radiograph remains essentially unchanged from previous imaging. There are no pleural effusions. There is no pneumothorax or other complications seen. Cardiomediastinal silhouette is unchanged.

IMPRESSION: Left Dobbhoff tube in place with tip in the proximal stomach, recommend advancing the tube several centimeters to put the tip more fully within the stomach. Otherwise, essentially unchanged chest radiograph.

SubjectID: 10277901, StudyID: 50083821, Comparison: None

FINAL REPORT

HISTORY: Respiratory distress, to assess for pulmonary edema.

FINDINGS: In comparison with the study of ___, there is continued enlargement of the cardiac silhouette with substantial pulmonary edema and bilateral pleural effusions, more prominent on the right. An impression on the lower cervical trachea to the right raises the possibility of a thyroid mass.

SubjectID: 10277901, StudyID: 55915561, Comparison: None

FINAL REPORT

HISTORY: Shortness of breath.

TECHNIQUE: Upright AP view of the chest.

COMPARISON: None.

FINDINGS: The heart size is mild to moderately enlarged. Aortic knob is prominent, suggesting dilatation of the thoracic aorta. Atherosclerotic calcification of the aortic arch is present. Opacification within the retrocardiac region may reflect a combination of a small pleural effusion with adjacent atelectasis. Hazy opacification within the mid lung fields is noted. There is no right-sided pleural effusion pneumothorax. No acute osseous abnormality seen.

IMPRESSION: 1. Left basilar opacification likely reflects a combination of a small pleural effusion and adjacent atelectasis. Infection, however, is not excluded. 2. Hazy opacification within the mid lung fields bilaterally is nonspecific, and could reflect an infectious or inflammatory process. Mild pulmonary edema is considered less likely.

SubjectID: 10277901, StudyID: 55153931, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chronic heart failure, pneumonia, evaluation for interval changes.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the pre-existing parenchymal opacities have slightly decreased in extent and severity   Keywords: decrease. However, a minimal right pleural effusion has slightly increased in extent and the presence of small left pleural effusion is likely. Unchanged size of the cardiac silhouette. Unchanged course of the left-sided PICC line.

SubjectID: 10277901, StudyID: 51503041, Comparison: None

FINAL REPORT

HISTORY: Pulmonary edema or pneumonia.

FINDINGS: In comparison with the study of ___, there is increasing bilateral hazy opacification of both lungs in a patient with substantial enlargement of the cardiac silhouette. Although this could all represent pulmonary edema, in the appropriate clinical setting the possibility of supervening pneumonia would have to be considered. Some hazy basilar opacification suggests possible small pleural effusions. There is some displacement of the lower cervical trachea to the left, suspicious for thyroid mass on the right. Of incidental note are several rounded opacifications in the region of the stomach, most likely representing pills. Poor definition of the left hemidiaphragm would be consistent with some substantial volume loss in the left lower lobe.

SubjectID: 10286475, StudyID: 57452571, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with h/o of effusions, RLL pneumonia // interval change in effusion, conslidation

TECHNIQUE: Portable chest

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.

SubjectID: 10286475, StudyID: 53501085, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CML, sepsis and recurrent CHF now s/p Right chest tube and left ___ // ? pneumothorax, improvement in effusions ? pneumothorax, improvement in effusions

IMPRESSION: In comparison with the study ___ ___, the patient has taken a much better inspiration. There is enlargement of the cardiac silhouette with left ventricular prominence, though the pulmonary vascularity is now essentially within normal limits and there is no definite evidence of right pleural effusion. Continued opacification the left base silhouetting the hemidiaphragm, most likely reflecting volume loss left lower lobe pleural fluid.

SubjectID: 10286475, StudyID: 55355476, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ yo male, with h/o CML on hydroxyurea, recent admitted for AMS thought to be ___ medication overdose, presenting with AMS, leukocytosis and hypoxia w/2L O2 requirement. // please assess for interval change - please perform 7AM on ___ please assess for interval change - please perform 7AM on 0

IMPRESSION: In comparison with the study of ___, there are lower lung volumes. Continued enlargement of the cardiac silhouette, probably with mild elevation of pulmonary venous pressure. Hazy opacification in the right hemithorax is again seen, consistent with layering pleural effusion. An area of more confluent opacification is suggested right above the minor fissure, raising the possibility of developing consolidation in the appropriate clinical setting. Poor definition of the left hemidiaphragm again is consistent with pleural fluid and volume loss in the left lower lobe.

SubjectID: 10287348, StudyID: 58427217, Comparison: None

FINAL REPORT

INDICATION: ___ year old man with hepatic encephalopathy. Placed Dobhoff // dobhoff placement (Staged study, will need two films)

TECHNIQUE: 2 subsequent closures of the abdomen and chest

COMPARISON: ___

IMPRESSION: The imaged portions the lungs demonstrate bibasilar atelectasis. The patient is status post median sternotomy. The cardiac size is mildly enlarged. A Dobbhoff tube is seen in appropriate position within the stomach after the second radiograph.

SubjectID: 10287348, StudyID: 54511447, Comparison: None

FINAL REPORT

INDICATION: ___M with confusion, weakness, liver disease // eval pna

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: ___.

FINDINGS: Right apical scarring is again noted. The lungs are otherwise clear without focal consolidation or effusion. The cardiomediastinal silhouette is stable. Mediastinal clips and median sternotomy wires are again noted. No acute osseous abnormalities.

IMPRESSION: No acute cardiopulmonary process.

SubjectID: 10306412, StudyID: 55248283, Comparison: None

FINAL REPORT

PORTABLE CHEST ___, ___

COMPARISON: Chest ___ ___ ___.

FINDINGS: Cardiac silhouette is mildly enlarged, and accompanied by widening of the azygos vein and pulmonary vascular congestion. Multifocal areas of patchy and linear opacity are present in the left mid and both lower lung regions, with slight improved aeration at both lung bases. These findings favor a multifocal atelectasis, but co-existing aspiration or pneumonia is possible in the appropriate clinical setting.

SubjectID: 10308375, StudyID: 57023953, Comparison: None

FINAL REPORT

INDICATION: ___-year-old female with chest tightness and low saturations. Evaluate for acute process.

COMPARISON: Chest radiographs on ___, ___ and ___.

TECHNIQUE: PA and lateral chest radiograph.

FINDINGS: Ill-defined patchy opacities are seen in the right lung base with an associated small right pleural effusion, which is also confirmed in the lateral view. A dense left-sided retrocardiac opacity abutting the left hemidiaphragm is unchanged since at least ___ compatible with a Bochdalek hernia. A small left pleural effusion is also likely present. There is biapical pleuro-parenchymal scarring, more conspicuous in the left apex. No other focal opacities are identified. Mild cardiomegaly is unchanged from prior. There is no pneumothorax.

IMPRESSION: Right lower lobe pneumonia. Small bilateral pleural effusions.

SubjectID: 10308375, StudyID: 55091382, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with new-onset CHF. Tachypneic and desatting to ___%. Assess for interval change.

COMPARISON: Chest radiograph ___, ___, ___.

TECHNIQUE: Single portable frontal chest radiograph.

FINDINGS: Interval increase in moderate-sized right pleural effusion, and right lower lobe opacity with new right upper lobe heterogeneous opacity. Unchanged left apical pleural thickening and scarring. No interval change in the dense retrocardiac opacity obscuring the left hemidiaphragm which represents a Bochdalek hernia. No pneumothorax or pulmonary edema. Heart size is partially obscured by the pleural parenchymal process. Mediastinal contour and hila are normal. No bony abnormality.

IMPRESSION: 1. Interval increase in moderate-sized right pleural effusion. 2. Worsening right lower lobe opacity and new right upper lobe opacity are likely due to evolving pneumonia or aspiration. Results were conveyed via telephone to primary team by Dr. ___ on ___ at 3:40 p.m. within 5 minutes of observation of findings.

SubjectID: 10313763, StudyID: 53754596, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Questionable pneumonia, pleural effusions.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is now evidence of bilateral moderate pleural effusions. In addition, an opacity is seen in the middle lobe, better appreciated on the lateral than on the frontal image. This opacity corresponds to pneumonia in the appropriate clinical setting, as suspected in the previous report. Unchanged size of the cardiac silhouette. No additional lung parenchymal findings.

SubjectID: 10313763, StudyID: 53636146, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___ CLINICAL

HISTORY: ___-year-old woman with chest pain, question pneumonia.

FINDINGS: Portable AP upright chest radiograph is obtained. There is airspace consolidation involving the bilateral lower lungs which could represent pneumonia with possible associated pleural effusion. A lateral view would aid in diagnosis. Heart size cannot be fully assessed due to silhouetting by adjacent consolidation. There is faint atherosclerotic calcification along the aortic knob. No pneumothorax. Upper lungs are well aerated. The bony structures appear intact.

IMPRESSION: Lower lung opacities could represent pneumonia with effusion. Would recommend dedicated PA and lateral views to more clearly assess.

SubjectID: 10313763, StudyID: 51527697, Comparison: worse

FINAL REPORT

AP CHEST, 3:29 A.M. ON ___

HISTORY: A ___-year-old woman with pneumonia and recent desaturation and tachycardia.

IMPRESSION: AP chest compared to ___: Pulmonary vascular congestion has worsened to the point of early pulmonary edema, increasing the small right pleural effusion as well as vascular caliber   Keywords: increasing, worse. Heterogeneous opacification at both lung bases could be any combination of asymmetric edema, atelectasis, aspiration, and pneumonia. Left lower lobe atelectasis has worsened. No pneumothorax. The heart is moderately enlarged and the azygos vein is borderline distended.

SubjectID: 10316033, StudyID: 59048456, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with s/p heartware // OG placement - nursing will call

COMPARISON: ___ at 13:29.

IMPRESSION: There has been placement of a nasogastric tube whose tip and side port are below the GE junction. There remains a prior feeding tube which is unchanged. The rest of the lines and tubes are also stable. Heart size is enlarged. There is unchanged pulmonary edema and a left retrocardiac opacity   Keywords: unchanged. There are no pneumothoraces.

SubjectID: 10316033, StudyID: 58536693, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with s/p heartware // eval for effusion

COMPARISON: Radiographs from ___

IMPRESSION: Support lines and tubes are unchanged in position. Heart size is enlarged but stable. There is a persistent left retrocardiac opacity. There remains mild pulmonary edema and airspace opacity within the left upper lobe, stable   Keywords: remains. There is likely a left-sided pleural effusion however this is obscured by the hardware. There are no pneumothoraces.

SubjectID: 10316033, StudyID: 57409239, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with Re-exploration for Bleeding s/p LVAD // eval for ptx, effusion. call cvicu house officer at ___ if there is any concern with findings

COMPARISON: Radiographs from ___

IMPRESSION: Endotracheal tube, Swan-Ganz catheter, left-sided AICD, and left ventricular assist device are unchanged. There has been placement of bilateral chest tubes. There is unchanged cardiomegaly. There has been development of consolidation within the right upper lobe, new since the previous study. Left retrocardiac opacity remains unchanged. There are no pneumothoraces.

SubjectID: 10316033, StudyID: 56838761, Comparison: worse

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old woman with s/p heartware // ?ptx s/p PA line placement Rt IJ

TECHNIQUE: Portable chest

COMPARISON: Portable chest radiograph dated ___ at 07:37

FINDINGS: Since 4 hours prior, there has been interval increase pulmonary edema   Keywords: increase. After confirmation with Dr. ___, an apical predominance of the edema is likely due to the patient's laying in ___ position prior to the radiograph thickening obtained. Severe cardiomegaly is unchanged. There has been interval removal of the left IJ Swan-Ganz catheter and placement of a right IJ Swan-Ganz catheter. A left IJ central venous catheter introducer remains in place. Mediastinal drains are essentially unchanged in position. An ET tube terminates 5 cm above the carina. An enteric tube side port projects over the proximal stomach. Neither costophrenic angle is visualized, but there no large pleural effusions are present.

IMPRESSION: Increased pulmonary edema with an apical predominance caused by a Trendelenburg positioning as described above   Keywords: increase.

NOTIFICATION: The findings were discussed by Dr. ___ with Dr. ___ on the telephone on ___ at 2:14 PM, proximally 20 minutes after discovery of the findings.

SubjectID: 10316033, StudyID: 56392162, Comparison: better

FINAL REPORT

EXAMINATION: Portable chest radiograph

INDICATION: ___ year old woman with LVAD // interval change

TECHNIQUE: Portable chest

COMPARISON: Portable chest radiographs dated ___

FINDINGS: Since 1 day prior, there has been substantial improvement in pulmonary edema, moderate at the right apex and mild elsewhere   Keywords: improve. Severe cardiomegaly is unchanged. The left costophrenic angle is not visualized, but there is no right pleural effusion. No pneumothorax. Substantial retrocardiac atelectasis is unchanged. An ET tube terminates 5.3 cm above the carina. A right-sided IJ Swan-Ganz catheter terminates in the proximal right pulmonary artery. An enteric tube passes into the stomach.

IMPRESSION: Substantially improved pulmonary edema, most pronounced in the right apex   Keywords: improve.

SubjectID: 10316033, StudyID: 56108243, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with s/p VAD/AVR/TVr // eval pulm edema eval pulm edema

COMPARISON: ___

IMPRESSION: Hardware appears to be in unchanged position. There is interval change in the direction of the Swan-Ganz catheter, please correlate with provided readings. There is interval progression of currently moderate pulmonary edema   Keywords: progression. Pacemaker leads are in unchanged position. No appreciable pneumothorax is seen.

SubjectID: 10316033, StudyID: 54080354, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman s/p Heartware now w low Pa2 // eval for pleural effusions, ETT position

COMPARISON: ___ at 16:39.

IMPRESSION: Tip of the endotracheal tube is 4 cm above the carina. Rest of the support lines and tubes are unchanged in position. There is a persistent left retrocardiac opacity and left-sided pleural effusion, unchanged. There is unchanged mild pulmonary edema   Keywords: unchanged. There are no pneumothoraces.

SubjectID: 10316033, StudyID: 52996004, Comparison: better

WET READ: ___ ___ ___ 10:53 PM Swan-Ganz terminates in the main pulmonary artery, similar to prior exam. Other lines and tubes in unchanged positions. -___ ______________________________________________________________________________

FINAL REPORT

EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM

INDICATION: ___ year old woman s/p VAD placement // eval PA line eval PA line

IMPRESSION: Comparison to ___. Unchanged position of the monitoring and support devices, in particular of the Swan-Ganz catheter. The ventricular assist device is also unchanged. Unchanged low lung volumes. Slightly improving pulmonary edema   Keywords: improving. No larger pleural effusions.

SubjectID: 10316033, StudyID: 52647330, Comparison: same

WET READ: ___ ___ 8:41 AM Feeding tube terminates in the stomach. --___

WET READ VERSION #___ ___ ___ 12:02 AM Feeding tube terminates in the stomach. -___ ______________________________________________________________________________

FINAL REPORT

EXAMINATION: DX CHEST PORT LINE/TUBE PLCMT 1 EXAM

INDICATION: ___ year old woman with s/p heartware // eval dobhoff position

TECHNIQUE: Single frontal view of the chest

COMPARISON: Study performed 7 hours earlier

IMPRESSION: Dobhoff tube tip isin the stomach. No other interval change from prior study   Keywords: no other interval change.

SubjectID: 10316033, StudyID: 50089402, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman s/p Heartware // eval for improvement of consolidation s/p bronchPLEASE DO FILM AT 1:30AM. THANKS!

COMPARISON: Radiographs from ___

IMPRESSION: There is no significant interval change   Keywords: no significant interval change. Support lines and tubes are unchanged in position. Cardiac silhouette is enlarged and stable. There remains pulmonary edema and a left retrocardiac opacity   Keywords: remains. There are no pneumothoraces.

SubjectID: 10316033, StudyID: 58038331, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman now s/p PA line exchange // Eval for position of PA line

FINDINGS: As compared to chest radiograph from the same day the Swan-Ganz catheter tip has been advanced and now projects in the region of the right pulmonary artery remains in good position. The IABP is approximately 1.7 Cm from the superior aortic arch. Moderate cardiomegaly and associated small to moderate left pleural effusion is unchanged.

IMPRESSION: Swan-Ganz catheter tip has been advanced and now projects in the region of the right pulmonary artery remains in good position.

SubjectID: 10316033, StudyID: 56490401, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF // pulm edema?

TECHNIQUE: Portable AP chest radiograph.

COMPARISON: Chest radiograph ___

FINDINGS: Supportive a monitoring equipment is unchanged in position compared to the prior study. Even allowing for the projection, the heart appears enlarged. There is prominence of the bilateral hila and pulmonary vasculature consistent with congestive heart failure. No frank pulmonary edema seen. Silhouetting left hemidiaphragm consistent with left lower lobe atelectasis. No pneumothorax or pleural effusion seen.

IMPRESSION: No significant interval change when compared to the prior study   Keywords: no significant interval change.

SubjectID: 10316033, StudyID: 56122988, Comparison: same

FINAL REPORT

INDICATION: ___ year old woman with new IABP and Swan placed, with to confirm placement of lines/tubes // PA line placement

COMPARISON: ___

FINDINGS: The right-sided Swan-Ganz catheter is in good position. The intra-aortic balloon pump is approximately 1 cm from the transverse portion of the aortic arch. Single lead defibrillator is in similar position. Moderate cardiomegaly. No interstitial pulmonary edema. The lungs are unchanged in appearance   Keywords: unchanged in appearance. No pneumothorax.

IMPRESSION: The right-sided Swan-___ catheter is in good position. The intra-aortic balloon pump is approximately 1 cm from the of the aortic arch.

SubjectID: 10316033, StudyID: 51318630, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with decompensated CHF // eval for interval change and position of swan

COMPARISON: Radiographs from ___

IMPRESSION: Support lines and tubes are unchanged in position. The tip of the Swan-Ganz catheter is again in the main right pulmonary artery. There is an unchanged left retrocardiac opacity and likely left-sided pleural effusion. There are no pneumothoraces.

SubjectID: 10316033, StudyID: 57289788, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with suggestion on labs that PA catheter has migrated to wedge position // ? interval change in positioning of PA catheter ? interval change in positioning of PA catheter

IMPRESSION: No relevant change as compared to ___   Keywords: no relevant change. The monitoring and support devices are in unchanged position, with the exception of the aortic balloon pump that has been minimally pulled back. The Swan-Ganz catheter has been minimally advanced. The device should be pulled back by approximately 3 cm. Unchanged retrocardiac atelectasis. Unchanged mild pulmonary edema and moderate cardiomegaly   Keywords: unchanged.

SubjectID: 10316033, StudyID: 55999797, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CHF awaiting VAD // please assess for pulmonary edema please assess for pulmonary edema

IMPRESSION: As compared to the previous image, the intra-aortic balloon pump has been further pulled back. The tip of the pump is now projecting almost 4 cm be low the upper most portion of the aortic arch. Mild pulmonary edema persists   Keywords: persists. Moderate cardiomegaly with retrocardiac atelectasis. No pneumonia.

SubjectID: 10316033, StudyID: 51803497, Comparison: better

FINAL REPORT

INDICATION: ___ year old woman with LVAD // interval change

FINDINGS: As compared to chest radiograph from 1 day prior, the IABP has been removed. The remaining support devices are unchanged. Interval improvement in the pulmonary vascular congestion   Keywords: improve. Moderate cardiomegaly with interval decrease in the pneumopericardium. Retrocardiac opacity is unchanged. No pneumothorax.

IMPRESSION: Slight interval improvement of pulmonary vascular congestion and pneumopericardium   Keywords: improve.

SubjectID: 10316033, StudyID: 51697762, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with PA catheter placement question, concern that it is wedged. // PA catheter placcment PA catheter placcment

IMPRESSION: As compared to the previous image, the Swan-Ganz catheter has been pulled back. The tip of the catheter now projects over the outflow tract of the right ventricle. Minimally improved ventilation at the left lung base. Unchanged mild pulmonary edema and moderate cardiomegaly   Keywords: unchanged. The aortic balloon pump is in unchanged correct position.

SubjectID: 10316033, StudyID: 56982822, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with cardiogenic shock and PA catheter placement // Please assess PA catheter placement Please assess PA catheter placement

IMPRESSION: As compared to the previous image, the position of the Swan-Ganz catheter is unchanged. It is located in the peripheral parts of the right pulmonary artery. The device could be pulled back by approximately 4 cm. Unchanged appearance of the cardiac silhouette. No pneumothorax. No overt pulmonary edema.

SubjectID: 10316033, StudyID: 50978616, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with cardiogenic shock // please eval pulm artery catheter placement please eval pulm artery catheter placement

IMPRESSION: In comparison with the study of ___, the Swan-Ganz catheter has been pulled back so that it now lies within the right pulmonary artery at the outer mediastinal level. Other monitoring and support devices are unchanged. Continued enlargement of the cardiac silhouette without appreciable vascular congestion. Mild increased opacification in the retrocardiac region could reflect some volume loss in the left lower lobe.

SubjectID: 10316033, StudyID: 55498926, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with non-ischemic cardiomyopathy // e/o pulm edema e/o pulm edema

IMPRESSION: In comparison with the study of ___, there is little change   Keywords: little change. Again there is substantial enlargement of the cardiac silhouette consistent with the diagnosis of cardiomyopathy. No appreciable vascular congestion or acute focal pneumonia. The left IJ catheter has been removed. Other monitoring and support devices are stable.

SubjectID: 10316033, StudyID: 50170087, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ F with history of a non-ischemic dilated cardiomyopathy (most recent LVEF ___%, diagnosed DCM ___ years ago), DM (A1c 9% now on insulin), HTN, Hypothyroidism, s/p ICD who presented as a direct admit from cardiology clinic with Dr. ___ ___ worsening dyspnea and evaluation for possible LVAD placement // ?interval change ?interval change

COMPARISON: ___

IMPRESSION: Left internal jugular line tip is at the level of lower SVC. Pacemaker defibrillator leads terminate in the right ventricle. Cardiomegaly is substantial. Pulmonary edema has slightly progressed, moderate, interstitial   Keywords: progressed. No pneumothorax is seen.

RECOMMENDATION(S): Reassessment of the patient after diuresis is recommended for documentation of interval improvement of pulmonary edema.

SubjectID: 10316033, StudyID: 55417421, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with acute decomp heart failure // CVL positioning, e/p pulm process CVL positioning, e/p pulm process

IMPRESSION: As compared to ___, 13:00, the Swan-Ganz catheter has been removed. The left internal jugular vein catheter as well as the left pectoral pacemaker remain in unchanged position. Unchanged moderate cardiomegaly with retrocardiac atelectasis. No pulmonary edema. No pleural effusions.

SubjectID: 10316033, StudyID: 51671394, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with advanced heart failure // interval change interval change

IMPRESSION: As compared to ___, no relevant change is seen   Keywords: no relevant change. The Swan-Ganz catheter and the pacemaker leads are in constant position. Moderate cardiomegaly no overt pulmonary edema. Retrocardiac atelectasis. No pneumonia, no pleural effusions.

SubjectID: 10320599, StudyID: 57967601, Comparison: None

FINAL REPORT

AP CHEST, 6:22 P.M., ___

HISTORY: AVR. Question pneumothorax after chest tube removal.

IMPRESSION: AP chest compared to ___ and earlier on ___: Small left apical pneumothorax is new since 3:08 p.m. Moderate right pleural effusion is unchanged. Postoperative widening of the cardiomediastinal silhouette is also stable. There is no pulmonary edema. Posterior fracture of a right middle rib is healed. ___ was paged; the change in the initial interpretation of no pneumothorax was discussed with the team member, ___, who responded at approximately 7:30am.

SubjectID: 10320599, StudyID: 57030234, Comparison: None

FINAL REPORT

PORTABLE AP CHEST FILM ___ AT 15:08 CLINICAL

INDICATION: Evaluate for pneumothorax with chest tube on waterseal. Comparison is made to the patient's prior study dated ___ at 12:42. Portable AP upright chest film, ___ at 15:08 is submitted.

IMPRESSION: 1. Status post median sternotomy with stable postoperative enlargement of the cardiac silhouette. Overall mediastinal contours are also stable. Interval extubation, removal of the nasogastric tube and removal of the right internal jugular Swan-Ganz catheter. A left basilar chest tube is not well visualized but appears to still be present. Basilar airspace opacity with layering effusions is seen likely representing compressive atelectasis. No evidence of pulmonary edema. No pneumothorax is seen.

SubjectID: 10320599, StudyID: 56816037, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male status post CABG with left apical pneumothorax. Evaluate for pneumothorax or effusion.

EXAMINATION: Single frontal chest radiograph.

COMPARISONS: ___.

FINDINGS: The previously noted small left apical pneumothorax is not appreciated. There are small bilateral left greater than right pleural effusions. There is bibasilar opacification, likely atelectasis. There are no new focal recurring opacities concerning for pneumonia. The cardiomediastinal and hilar contours are stable demonstrating tortuosity of the thoracic aorta with atherosclerotic calcification. The patient is status post median sternotomy and CABG. Multilevel degenerative changes of thoracolumbar spine as manifested by marginal osteophytic formation are stable.

IMPRESSION: No evidence of pneumothorax. Bibasilar atelectasis and small bilateral pleural effusions.

SubjectID: 10320599, StudyID: 57770341, Comparison: None

WET READ: ___ ___ ___ 7:52 AM 1. Interval placement of right-sided chest tube in grossly appropriate location. Hazy opacity in the right mid lung and new surgical chain sutures likely relates to recent right upper lobe wedge resection. 2. Prominence of the mediastinum likely relates to rightward patient rotation and AP technique, not appreciably changed since earlier same day chest radiograph. 3. Low lung volumes. More apparent left basilar and retrocardiac opacity may relate to atelectasis. 4. Right chest wall mild subcutaneous emphysema. C. Hostage

WET READ VERSION #1 ___ ___ ___ 11:52 PM 1. Interval placement of right-sided chest tube in grossly appropriate location. Hazy opacity in the right mid lung and new surgical chain sutures likely relates to recent right upper lobe wedge resection. 2. Prominence of the mediastinum likely relates to rightward patient rotation and AP technique, not appreciably changed since earlier same day chest radiograph. 3. Low lung volumes. More apparent left basilar and retrocardiac opacity may relate to atelectasis. 4. Right chest wall mild subcutaneous emphysema. C. Hostage ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p open RUL wedge // eval for PTX, chest tube placement eval for PTX, chest tube placement

IMPRESSION: In comparison with the earlier study of this date, there has been placement of a right chest tube without definite pneumothorax. Subcutaneous gas is seen along the right lateral chest wall with extension into the neck. Postsurgical changes are seen in the right hemithorax, especially in the mid zone. Opacification at the left base is consistent with volume loss in the lower lobe and probable small effusion. There is again enlargement of the cardiac silhouette with evidence of pulmonary vascular congestion.

SubjectID: 10320599, StudyID: 51734262, Comparison: None

FINAL REPORT

EXAMINATION: Chest radiograph

INDICATION: ___-year-old man with a history of right upper lobe wedge resection and diastolic heart failure, now status post fluid bolus. Concern for acute on chronic CHF.

TECHNIQUE: Portable AP chest radiograph

COMPARISON: Multiple prior chest radiographs, most recent from ___.

FINDINGS: Median sternotomy wires intact and aligned. Right apical chest tube position unchanged. Small, residual right apical pneumothorax and increased subcutaneous emphysema in the right chest wall and neck that suggests a continuing air leak. Small right pleural effusion and worsening atelectasis at the right base. Improved, small pleural effusion at the left base. Stable, mild cardiomegaly.

IMPRESSION: Small, residual right apical pneumothorax. Increased subcutaneous emphysema suggests continuing air leak. Worsening atelectasis at the right base.

SubjectID: 10320599, StudyID: 51132708, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with preop for vats wedge resection // preop Surg: ___ (R VATS wedge) preop

IMPRESSION: In comparison with the study of ___, there is again enlargement of the cardiac silhouette with elevated pulmonary venous pressure. Nodular opacification is again seen on the right. Overall, little change   Keywords: little change.

SubjectID: 10332328, StudyID: 59680396, Comparison: worse

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: Multiple priors, most recent dating ___ and prior CT, most recent dating ___. CLINICAL

HISTORY: Shortness of breath, hypoxemia, assess for pneumonia.

FINDINGS: Portable semi-upright AP view of the chest was provided. Underpenetrated technique and low lung volumes limit the evaluation. Allowing for this, there is increase in the bilateral pulmonary opacities which could represent pneumonia, multifocal versus atypical pulmonary edema   Keywords: increase. Please correlate clinically. The heart size cannot be assessed. The mediastinal contour is widened, though this is unchanged. No definite acute bony injury.

SubjectID: 10332328, StudyID: 58967133, Comparison: better

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old male with restrictive lung disease. Patient with acute on chronic hypoxemia. Evaluate for interval changes.

FINDINGS: Comparison is made to prior study from ___. There are low lung volumes and cardiomegaly which is stable. There is mild improvement of the pulmonary interstitial edema since the previous study   Keywords: improve. There remain opacities within the lung bases and likely bilateral pleural effusions. There are no large pneumothoraces seen.

SubjectID: 10336114, StudyID: 58646090, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Weakness.

COMPARISONS: ___.

TECHNIQUE: Chest, AP upright and lateral.

FINDINGS: The patient is status post coronary artery bypass graft surgery. The heart appears mildly enlarged. The cardiac, mediastinal and hilar contours appear unchanged. There is a moderate left-sided pleural effusion, probably with some degree of loculation along the left lateral hemithorax, as well as patchy parenchymal opacity, most likely compatible with atelectasis. On the right, there is also a pleural effusion, probably free-flowing and small to moderate in size. There is also a small pneumothorax on the right. The distance between the apical visceral pleural edge and the outer chest wall measures about 2.2 cm. A mild interstitial abnormality suggests mild pulmonary edema. Fissures are thickened. The bones are probably demineralized.

IMPRESSION: Pneumothorax on the right. Bilateral pleural effusions. Interstitial abnormality suggesting mild pulmonary edema. Although opacities at the lung bases, greater on the left than right, are probably compatible with atelectasis, underlying infectious process is not entiredly excluded by this examination.

SubjectID: 10336114, StudyID: 51313454, Comparison: None

FINAL REPORT

INDICATION: Severe aortic stenosis and pneumothorax.

COMPARISON: ___.

FINDINGS: Portable frontal radiograph of the chest demonstrates a stable right pneumothorax. A small right pleural effusion and the loculated left pleural effusion has increased in size. Increase in mild enlargement of the cardiac silhouette with mild pulmonary edema.

SubjectID: 10336412, StudyID: 58960299, Comparison: None

FINAL REPORT

HISTORY: Non-small cell lung cancer with increased dyspnea.

COMPARISON: ___

FINDINGS: Again seen is the area of opacity in the right mid to upper lung compatible with postobstructive pneumonia. superimposed on this is an alveolar infiltrate that has progressed slightly on the right. There is some mild pulmonary vascular redistribution.

IMPRESSION: Amount of fluid over load has increased compared to the prior study and there is increased alveolar infiltrate.

SubjectID: 10336412, StudyID: 55188201, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with history of non-small cell lung cancer who presents for followup evaluation of a post-obstructive pneumonia.

COMPARISON: Chest radiographs from ___, ___, ___ and CT from ___.

TECHNIQUE: Single AP portable chest radiograph.

FINDINGS: Severe right upper and lower lobe consolidation has worsened in the lower lobe and at least moderate right pleural effusion is larger. Vascular congesion and perihilar edema in the left lung have worsened   Keywords: worse. There is no pneumothorax. Moderate cardiomegaly is stable since at least ___.

IMPRESSION: Interval worsening of severe right pneumonia and moderate right pleural effusion. Increased mild pulmonary edema   Keywords: increase. The findings were discussed with Dr. ___ at 1:40pm by Dr. ___ by telephone on the day of the exam.

SubjectID: 10336412, StudyID: 53860818, Comparison: None

FINAL REPORT

CHEST ON ___

HISTORY: Dyspnea, question interval change.

FINDINGS: Again seen is the right upper lung opacity. There is now increased amount of alveolar infiltrate involving the right upper lung extending to the apex with some areas of increased opacity in the right lower lung as well. The left lung is clear. Findings are compatible with the patient's known right upper lobe mass with post-obstructive pneumonia. It is unclear if the worsened appearance in the right lung is due to lymphangitic tumor spread or infection. However, given the relatively rapid change in appearance, asymmetric pulmonary edema or infection are most likely.

SubjectID: 10336412, StudyID: 58249331, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with shortness of breath.

COMPARISON: Chest radiograph from ___. ONE VIEW OF THE CHEST: The lungs are well expanded and show bilateral interstitial and focal airspace opacities. The cardiomediastinal silhouette and hilar contours are normal. No pleural effusion or pneumothorax is present.

IMPRESSION: Moderate pulmonary edema.

SubjectID: 10336412, StudyID: 52082223, Comparison: None

WET READ: ___ ___ ___ 5:36 PM improved aeration of right lower and left lung with persistent dense opacification of right upper lobe. apex slightly obscured by mandible but no apical pneumothorax evident. stable cardiomediastinal contour. ___

WET READ VERSION #1 ______________________________________________________________________________

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Lung cancer, right pleural effusion, evaluation.

COMPARISON: ___.

FINDINGS: Since the previous radiograph, the extensive right upper lobe pneumonia is constant in extent and severity. The opacities in the right lower lobe have slightly decreased in extent. There is no evidence of pneumothorax. Moderate cardiomegaly with tortuosity of the thoracic aorta persists. No pleural effusions.

SubjectID: 10338515, StudyID: 59383295, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with CHF, SLE, CKD, chronic steroids presents with URI symptoms, ___ edema, concern for PNA // please assess for interval change, infection

TECHNIQUE: Single frontal view of the chest

COMPARISON: PORTABLE CHEST X-RAY ___

FINDINGS: The right internal jugular central venous catheter terminates in the mid SVC. Low lung volumes, cardiomegaly, and pulmonary vascular congestion remains stable   Keywords: remains, stable. There is no pneumothorax.

IMPRESSION: No evidence of pneumonia however difficult to exclude superimposed pneumonia without lateral view. No interval change in cardiomegaly and vascular congestion   Keywords: no interval change.

SubjectID: 10338515, StudyID: 54316986, Comparison: same

FINAL REPORT

INDICATION: ___-year-old male with right internal jugular central venous line placement. Evaluate line.

TECHNIQUE: Portable AP chest radiograph was obtained.

COMPARISON: Chest radiograph from ___ at 13:01.

FINDINGS: Evaluation is limited by motion. There has been interval placement of a right internal jugular central venous line which terminates in the proximal SVC. Lung volumes continue be low with mild pulmonary edema and cardiomegaly seen   Keywords: continue.

IMPRESSION: Right internal jugular central venous line terminates in the proximal SVC without procedural complications seen. Stable appearance of the chest with low lung volumes, cardiomegaly and pulmonary edema.

SubjectID: 10338515, StudyID: 51080146, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male with shortness of breath. Evaluate for infiltrate or edema.

TECHNIQUE: AP chest radiograph was obtained.

COMPARISON: Chest radiograph from ___, ___, ___ and ___.

FINDINGS: Lung volumes are low causing crowding of the central bronchovascular structures. The heart is mildly enlarged, and there is mild pulmonary vascular congestion. There is possible fluid along the right minor fissure, and no focal consolidation or pneumothorax is seen.

IMPRESSION: Low lung volumes. Mild cardiomegaly and pulmonary vascular congestion. Possible small right pleural effusion.

SubjectID: 10345163, StudyID: 59288808, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p CABG // eval for pleural effusions

COMPARISON: None.

FINDINGS: Compared with ___ at 18:23 , I doubt significant change. Again seen are low inspiratory volumes, sternal wires and prominence of the cardiomediastinal silhouette, and left lower lobe collapse and/or consolidation. There is upper zone redistribution, likely accentuated by low inspiratory volumes, without overt CHF. Although small right and left effusions cannot be excluded, no gross effusion is identified. As before, a right IJ central line is again seen, with tip over distal SVC.

IMPRESSION: Doubt significant change compared with ___ at 18:23

SubjectID: 10345163, StudyID: 58169997, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man s/p CABG // eval for pneumo

COMPARISON: ___

FINDINGS: Low inspiratory volumes. No obvious pneumothorax. The right-sided catheter is again seen overlying the distal SVC. The chest tubes and mediastinal tube have been removed. There is prominence of the cardiomediastinal silhouette and of the vascular markings, at least in part accentuated by low lung volumes. The possibility of background CHF cannot be excluded in this setting. The patient has known pre-existing cardiomegaly. Sternotomy wires noted.

IMPRESSION: As above.

SubjectID: 10345163, StudyID: 59107435, Comparison: None

FINAL REPORT

INDICATION: ___ year old man POD 1 AM rounds CABG // Eval for effusion, widened mediastinum. AM POD1

COMPARISON: Comparison is made with prior studies including ___.

IMPRESSION: Since the prior study, the endotracheal tube and nasogastric tubes have been removed. Bilateral chest tubes and mediastinal tube are unchanged. There is no pneumothorax or pneumomediastinum. There is a poor inspiratory effort making evaluation of the cardiac and mediastinal silhouette difficult. There is no CHF or dense consolidation. There is linear atelectasis in both lung bases.

SubjectID: 10349402, StudyID: 58607794, Comparison: None

FINAL REPORT

EXAM: Chest, frontal and lateral views. CLINICAL INFORMATION: Dementia with altered mental status.

COMPARISON: None.

FINDINGS: Frontal and lateral views of the chest were obtained. Dual-lead right-sided pacemaker is seen with leads extending to the expected positions of the right atrium and right ventricle. Left retrocardiac basilar opacity is seen, which could be due to atelectasis; however, underlying consolidation due to infection or aspiration is not excluded. There is no pleural effusion or pneumothorax. The cardiac silhouette is top normal to mildly enlarged. The aorta is somewhat tortuous.

IMPRESSION: Patchy medial left basilar retrocardiac opacity is nonspecific, could be due to atelectasis, but underlying infection or aspiration not excluded.

SubjectID: 10349402, StudyID: 53553938, Comparison: None

FINAL REPORT

HISTORY: Hypotension elevated lactate. Evaluate for pneumonia.

COMPARISON: ___.

FINDINGS: 2 views of the chest demonstrate a right pacemaker generator with atrial and ventricular leads. Bibasilar opacities are seen which correlate with areas of consolidation on the concurrently obtained CT of the abdomen and pelvis which may represent atelectasis or infection. The cardiac and mediastinal contours are normal. No pleural abnormality is perceived, although a small left pleural effusion was seen on the concurrently obtained CT of the abdomen and pelvis.

IMPRESSION: Bibasilar opacities better seen on the CT of the abdomen and pelvis which may represent atelectasis or consolidation. Small left pleural effusion is better seen on the concurrently obtained abdomen-pelvis CT.

SubjectID: 10352433, StudyID: 58205550, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with acute-onset unsteadiness, urinary incontinence today, expressive aphasia, altered mental status; borderline febrile

COMPARISON: Chest radiograph ___

FINDINGS: PA and lateral views of the chest provided. There are prominent bilateral interstitial marking including ___ B-lines, consistent with mild pulmonary edema. There is no focal consolidation, effusion, or pneumothorax. The cardiomediastinal silhouette is normal. Imaged osseous structures are intact. No free air below the right hemidiaphragm is seen.

IMPRESSION: Mild pulmonary edema, without pleural effusions.

SubjectID: 10352433, StudyID: 57245074, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with flash pulmonary edema // ?improvement of CXR

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Cardiomediastinal silhouette is unchanged including cardiomegaly but there is interval substantial improvement in pulmonary edema   Keywords: improve. No interval development of pleural effusions demonstrated although small amount of pleural fluid cannot be excluded. No pneumothorax. Right lower lung partial atelectasis is unchanged.

SubjectID: 10352433, StudyID: 54503910, Comparison: worse

FINAL REPORT

INDICATION: ___-year-old male with worsening tachypnea, wheezing, and tachycardia.

COMPARISON: Radiograph dated ___.

FINDINGS: Single portable upright chest radiograph demonstrate save rotated patient. The heart is mildly enlarged. Perihilar bilateral patchy opacities as well as indistinct central vessels are most suggestive of pulmonary edema. There is no large pleural effusion. Mediastinal and hilar contours are stable relative to prior radiograph dated ___. Osseous there is demonstrate chronic appearing multiple left-sided rib deformities.

IMPRESSION: Cardiomegaly with pulmonary edema, progressed since prior study dated ___   Keywords: progressed.

SubjectID: 10354217, StudyID: 56434512, Comparison: same

FINAL REPORT

HISTORY: CHF exacerbation.

FINDINGS: In comparison with study of ___, there is continued evidence of pulmonary vascular congestion, though it appears to be somewhat less than on the previous study   Keywords: continue. Bibasilar opacifications are again consistent with pleural effusion and atelectasis. Central catheter is unchanged.

SubjectID: 10354217, StudyID: 55908130, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with syncope.

COMPARISON: ___. CT from ___.

FINDINGS: AP and lateral views of the chest. Mild left mid lung opacity is again seen and suggestive of scarring and presence on prior CT. Ther is no large effusion. Cardiac silhouette is enlarged but stable. Aortic valve replacement is again seen. No acute osseous abnormalities detected.

IMPRESSION: No definite acute cardiopulmonary process.

SubjectID: 10364180, StudyID: 58995456, Comparison: same

FINAL REPORT

INDICATION: COPD, pneumonia, atypical layering of pulmonary edema. Now status post diuresis.

COMPARISON: ___.

FINDINGS: AP view of the chest. Patient has been extubated. Moderate cardiomegaly is again seen and the cardiomediastinal and hilar contours are unchanged. The right lower lobe consolidation slightly increased. Mild pulmonary edema is unchanged   Keywords: unchanged.

IMPRESSION: Increasing right lower lobe consolidation. Likely mild pulmonary edema is unchanged   Keywords: unchanged.

SubjectID: 10364180, StudyID: 54648261, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Hypercarbic respiratory failure, evaluation for endotracheal tube position.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, no relevant change is seen   Keywords: no relevant change. The lung volumes are slightly lower, potentially caused by lower ventilatory pressure. The tip of the endotracheal tube is in unchanged position. The tip projects 3 cm above the carina. The nasogastric tube shows unchanged course and position.

SubjectID: 10364180, StudyID: 54580640, Comparison: same

FINAL REPORT

INDICATION: COPD and CHF. Evaluate for change.

COMPARISON: ___ at 3:46 a.m.

FINDINGS: AP view of the chest. Right lower lobe consolidation is unchanged. Mild-to-moderate pulmonary edema is unchanged   Keywords: unchanged   Keywords: unchanged. No large pleural effusion. Cardiomediastinal and hilar contours are stable. No pneumothorax.

IMPRESSION: No significant change in right lower lobe consolidation. Mild-to-moderate pulmonary edema is unchanged.

SubjectID: 10364180, StudyID: 58976644, Comparison: same

FINAL REPORT

PORTABLE CHEST FILM ___ AT 827 CLINICAL

INDICATION: ___-year-old with CHF, COPD, right effusion, assess for interval change. Comparison to prior study of ___ at 242. Portable AP upright chest film ___ at 827 is submitted.

IMPRESSION: 1. Overall cardiac and mediastinal contours are stable. There continues to be a diffuse bilateral predominantly interstitial abnormality in the lungs with more focal vague opacity in the left upper peripheral lung   Keywords: continue. When compared to the most recent prior study, there is no significant interval change, although these findings are more pronounced when compared to studies from ___   Keywords: no significant interval change. Therefore, these findings favor persistent interstitial edema rather than an infectious process   Keywords: persistent. Clinical correlation would be advised. There is a small layering left effusion. There is overall improved aeration at the right base when compared to more remote studies. Heart remains enlarged. Calcification of the aorta consistent with atherosclerosis. No pneumothorax.

SubjectID: 10364180, StudyID: 55260695, Comparison: worse

FINAL REPORT

HISTORY: Shortness of breath after blood transfusion, to assess for pulmonary edema.

FINDINGS: In comparison with study of ___, there is some increase in the bilateral pulmonary opacifications, consistent with worsening pulmonary vascular congestion   Keywords: worse, increase. In the appropriate clinical setting, superimposed pneumonia would be difficult to exclude.

SubjectID: 10364180, StudyID: 58256366, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with intubation // eval ET tube

COMPARISON: Prior exam from approximately 1 hr earlier.

FINDINGS: AP portable supine view of the chest. There has been interval intubation with the tip of the endotracheal tube residing approximately 4 cm above the carina. Mild cardiomegaly and pulmonary interstitial edema persists   Keywords: persists. No large effusions are present.

IMPRESSION: ET tube positioned appropriately. Persistent cardiomegaly and interstitial pulmonary edema   Keywords: persistent.

SubjectID: 10364180, StudyID: 53383509, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___F with resp distress/hypoxia // r/o infiltrate,failure

COMPARISON: ___. PET-CT scan from ___.

FINDINGS: AP portable upright view of the chest. In this patient with known COPD plans lung cancer, diffuse interstitial opacities are concerning for edema. The known pulmonary nodular opacities are better visualized on the prior PET-CT scan. Small effusions are difficult to exclude. The heart appears mildly enlarged. Aortic atherosclerotic calcifications noted. No acute bony injuries.

IMPRESSION: Mild cardiomegaly with interstitial pulmonary edema and probable small bilateral pleural effusions. Pulmonary nodular opacity seen on prior PET-CT scan poorly visualized on this chest radiograph.

SubjectID: 10364180, StudyID: 58182875, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, intubated // Evaluate ET Tube placement

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the endotracheal tube and the nasogastric tube are in constant position. The lung volumes are decreasing and there is a new parenchymal opacity at the right lung bases. Overall the opacity could reflect atelectasis, newly appeared pneumonia is another differential diagnostic consideration. Moderate cardiomegaly persists. Mild fluid overload. No larger pleural effusions.

SubjectID: 10364180, StudyID: 54752515, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with COPD, leukocytsois // infiltrate vs atelectasis

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the lung volumes have increased, likely reflecting improved ventilation. The endotracheal tube and the nasogastric tube have been removed. The large parenchymal opacities at the right lung basis and in the left perihilar areas, however, are unchanged. Unchanged appearance of the moderately enlarged cardiac silhouette. No larger pleural effusions. No new parenchymal opacities   Keywords: new.

SubjectID: 10364180, StudyID: 58152775, Comparison: same

FINAL REPORT

INDICATION: COPD, volume overload, and shortness of breath. Evaluate for change.

COMPARISONS: Chest radiograph from ___.

TECHNIQUE: A single upright AP view of the chest was obtained.

FINDINGS: Again, there is moderate pulmonary edema, not significantly changed from the prior exam   Keywords: not significantly changed, again. Right basilar atelectasis is stable. There is no new consolidation. There is no pleural effusion or pneumothorax. The aorta is tortuous and calcified. The heart is moderately enlarged.

IMPRESSION: No significant change in the moderate pulmonary edema   Keywords: no significant change.

SubjectID: 10364180, StudyID: 55680773, Comparison: worse

FINAL REPORT

HISTORY: ___-year-old female with known diastolic congestive heart failure and COPD. Evaluate for pulmonary edema or focal consolidation.

COMPARISON: Multiple prior chest radiographs most recently dated ___.

FINDINGS: Heart size is only top normal. Nevertheless, worsened moderate pulmonary edema and small pleural effusions are presumably cardiac in origin   Keywords: worse. There is increased density within the right lower lobe, is dependent atelectasis or pneumonia0. No pneumothorax.

IMPRESSION: 1. Worsening pulmonary edema, presumably cardiac   Keywords: worse. Emphysema. 2. Right lower lobe atelectasis or pneumonia. Recommend follow up radiographs to document clearance with treatment of edema.

SubjectID: 10388429, StudyID: 57889015, Comparison: None

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: ___-year-old female with history of shortness of breath at rest, discharged yesterday from ___.

COMPARISON: ___.

FINDINGS: Single frontal view of the chest was obtained. A tube plus catheter is seen projecting over the right hemithorax. There are bilateral pleural effusions with overlying atelectasis, underlying consolidation is difficult to exclude. Cardiac and mediastinal silhouettes are stable.

IMPRESSION: Bilateral pleural effusions with overlying atelectasis. Underlying consolidation not excluded.

SubjectID: 10388429, StudyID: 52731514, Comparison: worse

FINAL REPORT

PORTABLE CHEST

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette is enlarged, and accompanied by mild pulmonary vascular engorgement, new perihilar haziness and more confluent opacities at the bases, accompanied by small effusions   Keywords: new. Findings are likely due to perihilar and basilar edema, but superimposed process such as aspiration at the lung bases is also possible. Followup radiographs may be helpful.

SubjectID: 10391104, StudyID: 58989850, Comparison: better

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with severe TR, ?PNA // interval change in effusion

IMPRESSION: As compared to ___ chest radiograph, bilateral pleural effusions have apparently decreased in size with residual moderate right and small to moderate left pleural effusions remaining. Pulmonary vascular congestion is accompanied by decreasing extent of pulmonary edema   Keywords: decreasing. Substantial bibasilar atelectasis and or consolidation persists adjacent to the pleural effusions.

SubjectID: 10391104, StudyID: 52630250, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with h/o ?COPD, CHF with EF ___% hypoxic to 80s // pulmonary pathology

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Biventricular pacer is in place. Large pleural effusion is demonstrated and there is potential worsening of congestive heart failure seen as mild vascular congestion   Keywords: worse.

SubjectID: 10391104, StudyID: 56846827, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with fever, cough dyspnea. // r/o pneumonia

COMPARISON: No previous films on PACs record for comparison.

FINDINGS: There is probable background COPD, with parenchymal scarring. Heart size is at the upper limits of normal, borderline enlarged. There is mild upper zone redistribution. There are increased interstitial markings and peribronchial cuffing   Keywords: increase. There are some more focal areas of increased markings in the left mid and lower zones and right base medially. The significance of this is uncertain, including whether represents an acute or chronic finding. This could represent a combination of parenchymal scarring and CHF or an infectious or inflammatory infiltrate. No frank consolidation or air bronchograms and no effusion is identified.

IMPRESSION: Probable background COPD. Increased interstitial markings in both lungs   Keywords: increase. Please see comment above.

SubjectID: 10391104, StudyID: 51592833, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with cough, concern for PNA // eval for PNA

COMPARISON: Chest x-ray from ___ at 556

FINDINGS: Compared with earlier the same day, I doubt significant interval change. Again seen is cardiomegaly, upper zone redistribution, and increased interstitial markings, including focally more pronounced areas in the left mid and lower zones and in the right cardiophrenic region. As before, it is uncertain whether these represent acute or chronic findings and whether they represent a a single process alone or a process superimposed on some background interstitial changes. The potential differential includes background scarring, interstitial edema, inflammatory infectious processes. The presence of more confluent opacity at the left mid-zone makes it difficult to exclude an acute pneumonic infiltrate.

IMPRESSION: Increased interstitial markings, with focally pronounced areas in left mid zone and both bases, similar to a film obtained earlier the same day   Keywords: increase. The possibility of a focal pneumonic infiltrate cannot be excluded.

SubjectID: 10391104, StudyID: 56712025, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with AVJ ablation and PPM placement now with severe flank/abdominal pain // eval PPM lead placement

TECHNIQUE: AP view of the chest

COMPARISON: Priors most recent on ___

FINDINGS: There has been interval placement of a left-sided pacer and dual leads. The right ventricular lead overlies the left hemidiaphragm on this single view. The heart is moderately enlarged with stable in size from the prior exam. The cardiomediastinal and hilar contours are within normal limits. There is no focal consolidation, effusion or pneumothorax. No evidence of pulmonary edema with minimal pulmonary vascular engorgement.

IMPRESSION: No evidence of pneumothorax. Pacer and leads leads in expected position.

SubjectID: 10391104, StudyID: 53814102, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman s/p AVJ ablation and PPM on ___ // pacemaker lead placement

TECHNIQUE: Chest two views

COMPARISON: ___.

FINDINGS: Compared to the prior study there is no significant interval change   Keywords: no significant interval change.

IMPRESSION: No change   Keywords: no change.

SubjectID: 10407582, StudyID: 58895720, Comparison: None

FINAL REPORT

AP CHEST, 11:05 A.M., ___

HISTORY: ___-year-old man with pneumothorax after right fiducial seed placements. Chest tube on suction.

IMPRESSION: Three frontal views of the chest, all show the complete resolution of the previous moderate right pneumothorax, now with only a tiny apical component. Pigtail pleural drain unchanged in position in the right lower chest anterolaterally. Both lungs are clear. There is no appreciable pleural effusion, and the cardiomediastinal silhouette is unremarkable.

SubjectID: 10407582, StudyID: 57081381, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male patient with right pneumothorax, status post pigtail removal.

COMPARISON: Prior chest radiograph from ___ at 6:04.

TECHNIQUE: PA and lateral chest radiographs.

FINDINGS: As compared to prior chest radiograph from ___, there has been interval removal of a right-sided pigtail catheter. Miniscule collection of right apical air is identified. There are no pleural effusions. Cardiomediastinal and hilar contours are within normal limits. There is calicifaction of the mitral annulus. Fiducial markers are again noted.

IMPRESSION: Miniscule collection of right apical air.

SubjectID: 10407582, StudyID: 54453540, Comparison: None

FINAL REPORT

INDICATION: ___-year-old male patient with right pneumothorax post fiducial seed placement. Study requested to rule out pneumothorax, now with chest tube on waterseal.

COMPARISON: Prior chest radiograph from ___ at 11:05.

TECHNIQUE: PA and lateral chest radiographs.

FINDINGS: As compared to prior chest radiograph from ___, there has been some increase of a small right apical pneumothorax. A right pleural pigtail catheter remains in unchanged position. Left lung is clear. There are no new focal consolidations. The cardiomediastinal and hilar contours are within normal limits.

IMPRESSION: Interval increase of a small right apical pneumothorax.

SubjectID: 10407582, StudyID: 52749044, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Fiducial marker placement. Evaluation for pneumothorax.

COMPARISON: Pre-interventional CT from ___.

FINDINGS: The patient has developed a right apical pneumothorax. The diameter of the pneumothorax is approximately 1 cm. There is no evidence of tension. Fiducial seeds are seen in the right upper abdomen. Previously present pleural effusions are no longer visible. Normal size of the heart. Normal hilar and mediastinal contours.

SubjectID: 10407582, StudyID: 50299239, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Followup of pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the extent of the pre-existing right pneumothorax has increased. The pneumothorax is at least 3 times wider than previously. In addition, there is very mild depression of the right hemidiaphragm, potentially suggesting beginning tension. No other change   Keywords: no other change. At the time of dictation and observation, Dr. ___ was paged for notification, 4:02 p.m., on ___.

SubjectID: 10407730, StudyID: 57977401, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman with CAD, renal failure on HD, CHF, and now significant SOB // assess for pulmonary edema, pleural effusions, or other intrathoracic pathology that might explain severe SOB assess for pulmonary edema, pleural effusions, or other intr

IMPRESSION: In comparison with the study ___ ___, there is substantial increase in the degree of pulmonary edema with continued enlargement of the cardiac silhouette and blunting of the costophrenic angles   Keywords: increase. The central catheter and pacer device remain in place. In the appropriate clinical setting, the opacification at the left mid and lower zones could reflect superimposed pneumonia.

SubjectID: 10407730, StudyID: 53162706, Comparison: better

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: History: ___F with dyspnea and productive cough // ? process

TECHNIQUE: Chest Frontal and Lateral

COMPARISON: ___

FINDINGS: Right-sided large-bore central venous catheter is again seen terminating in the right atrium. Dual lead right-sided pacemaker is stable in position. There is persistent blunting of the bilateral costophrenic angles suggesting trace pleural effusions with overlying atelectasis. Perihilar opacities are consistent with pulmonary edema which appear grossly stable to possibly minimally decreased as compared to the prior study   Keywords: decrease. The cardiac silhouette remains enlarged. The aorta is calcified.

IMPRESSION: Small bilateral pleural effusions again seen. Pulmonary edema which may be slightly improved since the prior study   Keywords: improve. Persistent cardiomegaly.

SubjectID: 10407730, StudyID: 57669115, Comparison: None

FINAL REPORT

STUDY: AP chest; ___. CLINICAL

HISTORY: ___-year-old woman with worsening shortness of breath. Evaluate for acute process.

FINDINGS: Comparison is made to prior study from ___. There is cardiomegaly, which is stable. There is a right-sided dual-lead pacemaker, which is unchanged. There is worsening of the left retrocardiac opacity with likely small bilateral pleural effusions. There are no pneumothoraces.

SubjectID: 10407730, StudyID: 56709687, Comparison: worse

FINAL REPORT

HISTORY: Flash pulmonary edema.

FINDINGS: In comparison with the earlier study of this date, there is continued and probably worsening pulmonary edema, consistent with clinical history   Keywords: worse. The left hemidiaphragm is poorly seen, suggesting some pleural fluid and volume loss on this side. Pacer leads are in satisfactory position in this patient with previous CABG procedure and intact midline sternal wires.

SubjectID: 10407730, StudyID: 54291346, Comparison: better

FINAL REPORT

HISTORY: Flash pulmonary edema, to assess for improvement.

FINDINGS: In comparison with study of ___, there are lower lung volumes, though the degree of pulmonary venous congestion has substantially decreased   Keywords: decrease. Continued enlargement of the cardiac silhouette in a patient with intact midline sternal wires after CABG procedure and a dual-channel pacer device in place.

SubjectID: 10407730, StudyID: 57148256, Comparison: None

FINAL REPORT

INDICATION: ___ year old woman with cough // r/o acute process

TECHNIQUE: Upright PA and lateral chest

COMPARISON: Chest radiographs ___, ___, and ___.

FINDINGS: Dual lead right chest wall pacemaker is in stable position. Median sternotomy wires appear intact. Surgical clips project over the mediastinum. Right internal jugular hemodialysis catheter terminates in the right atrium. Mild cardiomegaly is unchanged. The mediastinal and hilar contours are normal. Small bilateral pleural effusions are redistributed with the patient upright and likely not significantly changed since the prior study. There is no evidence of pneumonia. There is no pneumothorax.

IMPRESSION: No evidence of pneumonia. Small bilateral pleural effusions are redistributed but not significantly changed overall.

SubjectID: 10407730, StudyID: 53088898, Comparison: worse

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman with CAD, now with SOB // assess for interval change, pulm edema

COMPARISON: ___, 15:12

IMPRESSION: As compared to the previous radiograph, the patient has developed moderate pulmonary edema   Keywords: develop. In addition, there is a left pleural effusion that increases in size. The retrocardiac atelectasis that pre existed is also increased. Unchanged moderate cardiomegaly. The alignment of the sternal wires is constant. Unchanged pacemaker and dialysis catheter. At the time of dictation a pager was placed to the referring physician for

NOTIFICATION:.

SubjectID: 10407730, StudyID: 54681780, Comparison: better

FINAL REPORT

EXAM: Chest, AP upright and lateral views. CLINICAL INFORMATION: Status post non-ST elevation MI and pulmonary edema with persistent productive cough and exertional shortness of breath.

COMPARISON: ___.

FINDINGS: Frontal and lateral views of the chest were obtained. Dual-lead right-sided pacer device is again seen with leads extending to the expected positions of the right atrium and right ventricle. Pulmonary edema persists, although appears somewhat improved since the prior study   Keywords: improve. There are likely small bilateral pleural effusions. Cardiac silhouette is slightly less prominent which may be due to differences in technique and patient position.

IMPRESSION: Moderate interstitial edema, decreased since the prior study   Keywords: decrease. Small bilateral pleural effusions.

SubjectID: 10417160, StudyID: 57398211, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Crackles, oxygen requirement, evaluation for pulmonary edema.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, assessment for volume overload.

COMPARISON: ___. As compared to the previous radiograph, the moderate cardiomegaly and the signs of mild fluid overload persist. In addition, there is a zone of increased parenchymal opacity at the left lung base, combined to air bronchograms and minimal blunting of the costophrenic sinus. Findings are highly suggestive of newly occurred pneumonia. At the time of dictation and observation, 9:21 a.m., on ___, the referring physician, ___. ___, covered by Dr. ___, was paged for notification. A telephone conversation occurred one minute later.

SubjectID: 10417160, StudyID: 53970814, Comparison: better

FINAL REPORT

CHEST RADIOGRAPH PERFORMED ON ___

COMPARISON: Chest CT from ___ as well as a chest radiograph from ___. CLINICAL

HISTORY: ___-year-old female with new AFib, shortness of breath, question pulmonary edema or pneumonia.

FINDINGS: AP and lateral views of the chest were obtained with patient positioned upright. In comparison with prior chest radiographs and chest CT, there is improvement in scattered opacities seen on prior exam with near-complete resolution   Keywords: improve. There are coarsened interstitial markings which could represent component of fibrosis. No new consolidation is seen. No effusion or pneumothorax. Patient rotation limits evaluation of the mediastinum. The heart size appears grossly stable and top normal in overall size. The imaged osseous structures appear intact.

IMPRESSION: Interval improvement in previously noted scattered pulmonary opacities   Keywords: improve. There is a probable component of fibrosis likely accounting for interstitial coarsening.

SubjectID: 10432951, StudyID: 59788680, Comparison: same

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: COPD, oxygen requirement.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, there is unchanged moderate cardiomegaly with moderate pulmonary edema   Keywords: unchanged. In addition, there is increasing volume loss of the right upper lobe with subsequent opacification of this anatomic region, potentially representing recent or developing pneumonia. The nasogastric tube has been removed. The observation was made at the time of dictation, 11:39 a.m., on ___. At the same time the referring physician, ___. ___, was paged for notification.

SubjectID: 10432951, StudyID: 56640608, Comparison: same

FINAL REPORT

INDICATION: PICC line in proximal SVC has been cleaned and PICC pulled out slightly, please evaluate placement.

COMPARISON: Comparison is made to multiple chest radiographs, most recently dated ___.

FINDINGS: Interval withdrawal of right-sided PICC line with tip terminating in the upper superior vena cava. No pneumothorax identified. Nasogastric tube is seen coursing into stomach and out of view. There is a persistent right hemidiaphragm elevation with increased right lower lung consolidation, likely due to right middle lobe collapse. Unchanged left retrocardiac opacity likely represents combination of atelectasis and effusion, though cannot exclude developing infectious process. Pulmonary edema is unchanged   Keywords: unchanged. Stable bilateral pleural effusions.

IMPRESSION: Interval withdrawal of right PICC line with tip in the upper superior vena cava. Increased right middle lung collapse. Stable bilateral pleural effusions and retrocardiac opacification.

SubjectID: 10432951, StudyID: 54910240, Comparison: same

FINAL REPORT

INDICATION: ___-year-old female with multiple medical problems, now with somnolence and worsening hypoxia after p.o. challenge yesterday, here to evaluate for evidence of aspiration or worsening pleural effusion.

COMPARISON: Chest radiographs, last performed on ___. PORTABLE FRONTAL CHEST RADIOGRAPH: Opacifications at the bilateral bases, right greater than the left, likely represent small bilateral pleural effusions with associated atelectasis, now with worsening right middle lobe atelectasis compared to ___. The right upper lobe opacity seen on the preceding radiograph is no longer present which likely represents resolved right upper lobe atelectasis. Mild pulmonary edema is unchanged. No pneumothorax is present. A right-sided PICC line is unchanged in position with the tip terminating in the upper SVC. The cardiomediastinal silhouette is moderately enlarged but unchanged.

IMPRESSION: 1. Increased bibasilar opacification on the right greater than the left, consistent with small bilateral pleural effusions with associated atelectasis, worse in the right middle lobe. Superimposed pneumonia cannot be excluded in the appropriate clinical setting. 2. Improved aeration at the right upper lobe consistent with resolved atelectasis. 3. Persistent mild pulmonary edema   Keywords: persistent.

SubjectID: 10432951, StudyID: 51410941, Comparison: same

FINAL REPORT

HISTORY: NG tube replacement.

FINDINGS: The NG tube extends to the lower body of the stomach with the side hole beyond the esophagogastric junction. Otherwise, little change   Keywords: little change.

SubjectID: 10432951, StudyID: 59645538, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with history of severe COPD and restrictive lung disease, obesity and hypoventilation.

FINDINGS: There is a nasogastric tube whose side port and tip are in the esophagus and this needs to either be removed or advanced at least ___-25 cm for more optimal placement. There is a right-sided central venous line whose tip in the proximal SVC. This could be advanced 6-7 cm for more optimal placement. Heart size is enlarged. There is some atelectasis at the lung bases. There is a left retrocardiac opacity. There are bilateral pleural effusions. No pneumothoraces are identified.

SubjectID: 10432951, StudyID: 58859243, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with delirium, repositioning of nasogastric tube.

FINDINGS: Comparison is made to the prior study performed earlier. The nasogastric tube has been advanced and the tip and side port are below the GE junction. The right-sided central venous catheter has the distal lead tip in the proximal SVC and could be advanced 6-7 cm for more optimal placement. There is unchanged cardiomegaly and a left retrocardiac opacity. There is also atelectasis at both lung bases, right side worse than left. No pneumothoraces are identified.

SubjectID: 10432951, StudyID: 59193599, Comparison: better

FINAL REPORT

INDICATION: Restrictive lung disease and worsening hypoxia. Please evaluate pulmonary edema or hypoxia.

COMPARISON: Comparison is made to multiple chest radiographs, most recently dated ___.

FINDINGS: Single portable chest radiograph demonstrates persistent though minimally improved mild to moderate pulmonary edema with slightly improved aeration of the bilateral upper lungs, left greater than right   Keywords: improve. Bibasilar opacifications noted, likely combination of atelectasis and bilateral pleural effusions, though concurrent infectious process cannot be appreciated. Endotracheal tube ends 2.5 cm above the carina. The nasogastric tube is seen coursing into stomach and out of view.

IMPRESSION: Minimally improved pulmonary edema with stable large bilateral pleural effusions   Keywords: improve. Bibasilar opacifications likely combination of atelectasis and effusion, though concurrent infectious process is a possibility in the appropriate clinical setting.

SubjectID: 10432951, StudyID: 58812506, Comparison: better

WET READ: ___ ___ ___ 9:44 PM ETT ends 3.3 cm above the level of the carina, appropriately positioned. Mild-to-moderate interstital pulmonary edema is decreased. Moderate bilateral pleural effusions persist. ______________________________________________________________________________

FINAL REPORT

AP CHEST, 6:12 P.M. ON ___

HISTORY: Check new ET tube.

IMPRESSION: AP chest compared to ___: New ET tube in standard placement. Nasogastric tube passes below the diaphragm and out of view. Lung volumes have improved, and mild pulmonary edema is more uniformly distributed   Keywords: improve. Small bilateral pleural effusions are presumed. Mild-to-moderate cardiomegaly has improved possibly because of positive pressure ventilator support. No pneumothorax.

SubjectID: 10432951, StudyID: 58494531, Comparison: worse

FINAL REPORT

INDICATION: Restrictive lung disease with rising leukocytosis.

COMPARISON: Radiograph available from ___. FRONTAL CHEST RADIOGRAPH: The heart is mildly enlarged. There is worsening of bilateral pleural effusions as well as central vascular congestion. Moderate pulmonary edema is again seen. There is no large pneumothorax. The apices are obscured by the patient's head.

IMPRESSION: Worsening bilateral pleural effusions with unchanged moderate edema   Keywords: worse. Superimposed consolidation, particularly at the bases, cannot be excluded.

SubjectID: 10432951, StudyID: 56441629, Comparison: better

FINAL REPORT

HISTORY: Mucus plug status post intubation. CHEST, SINGLE AP VIEW. The tip of the ET tube is not well delineated. It appears to overlap the NG tube and may lie approximately 8.3 cm above the carina at the level of the upper clavicle. An NG tube is present -- the tip overlies the fundus. There is prominence of the cardiomediastinal silhouette and left lower lobe collapse and/or consolidation. There is upper zone re-distribution and diffuse vascular blurring. There is increased opacity at the right base which could represent subsegmental or segmental atelectasis, with an elevated right hemidiaphragm. I suspect the presence of a small right effusion as well. There is increased retrocardiac density, with left lower lobe collapse and/or consolidation. No gross left effusion. Prominence of the main pulmonary artery is suggested. The hila also appear prominent.

IMPRESSION: 1. ET tube approximately 8.3 cm above the carina. Please see comment. 2. Cardiomegaly with suspected pulmonary artery enlargement. 3. Findings consistent with CHF. Compared with ___ at 2:40 a.m., the CHF findings are improved   Keywords: improve. 4. Left lower lobe collapse and/or consolidation. 3. Suspected atelectasis at the right base with elevated right hemidiaphragm. This is improved c/w with ___ at 2:40 am, but interval improvement could be also relate to differences in positioning, as the current film was obtained semi-erect.

SubjectID: 10432951, StudyID: 55827326, Comparison: None

FINAL REPORT

INDICATION: NG tube placement.

COMPARISON: Radiograph available from ___. PORTABLE CHEST RADIOGRAPH: Since ___ the patient has been extubated. There is a new nasogastric tube terminating within the stomach. The heart is enlarged. Bilateral pleural effusions and superimposed mild pulmonary edema are stable. There is no pneumothorax. Bibasilar atelectasis is also present.

IMPRESSION: 1. NG tube terminating within the stomach. 2. Unchanged small bilateral pleural effusions, bibasilar atelectasis, and superimposed edema.

SubjectID: 10432951, StudyID: 53855318, Comparison: same

FINAL REPORT

INDICATION: COPD, CHF, presenting with hypoxia.

COMPARISON: Radiograph available from ___. FRONTAL CHEST RADIOGRAPH: The heart is enlarged. The hila are again very enlarged bilaterally. There is superimposed central vascular congestion with moderate pulmonary edema. Bilateral pleural effusions are again seen, worse on the right. There is no pneumothorax. The right lung apex is obscured by an overlying object.

IMPRESSION: Cardiomegaly with superimposed moderate pulmonary edema and a right pleural effusion, unchanged since ___   Keywords: unchanged. Persistant hilar prominence may reflect underlying pulmonary arterial hypertension.

SubjectID: 10432951, StudyID: 57949669, Comparison: None

FINAL REPORT

INDICATION: Severe COPD with respiratory pathology.

COMPARISON: Radiograph available from ___. FRONTAL CHEST RADIOGRAPH: A nasogastric tube terminates within the stomach. Moderate cardiomegaly is unchanged. Moderate bilateral pleural effusions have enlarged since ___. Underlying bibasilar atelectasis appears unchanged. There is no pneumothorax.

IMPRESSION: Worsening moderate bilateral pleural effusions.

SubjectID: 10432951, StudyID: 55283260, Comparison: same

FINAL REPORT

INDICATION: NG tube placement.

COMPARISON: Radiograph available from ___. FRONTAL CHEST RADIOGRAPH: Moderate cardiomegaly, large bilateral pleural effusions, and mild pulmonary edema are unchanged since the 1:59 a.m. study. The mediastinal contour is normal. A nasogastric tube terminates within the stomach. There is no pneumothorax.

IMPRESSION: NG tube terminating within the stomach. Unchanged bilateral pleural effusions and mild interstitial edema   Keywords: unchanged.

SubjectID: 10440642, StudyID: 59734158, Comparison: None

FINAL REPORT

CHEST RADIOGRAPHS

HISTORY: Shortness of breath; question pneumonia.

COMPARISONS: ___, radiographs from ___ and chest CT from ___.

TECHNIQUE: Chest, PA and lateral.

FINDINGS: There is similar moderate cardiomegaly. The aortic arch is calcified. The mediastinal and hilar contours appear unchanged. There are prominent indistinct central pulmonary vessels as well as a widespread mild interstitial process, which is suggestive of mild pulmonary fibrosis and that was seen previously predominantly in the right hemithorax, but with suspected superimposed vascular congestion. Opacities in the right infrahilar and left retrocardiac regions have improved substantially, but with persistent retrocardiac opacification and small suspected left-sided pleural effusion. Left basilar opacification is probably compatible with chronic atelectasis associated with a substantial hiatal hernia, however, which is hard to directly visualize on this study but which was shown on the prior CT. The bones appeared demineralized. There is exaggerated kyphosis along the mid thoracic spine, as seen previously, and bones are not well delineated. Suboptimally imaged on the lateral view only is the upper part of an abdominal aortic stent.

IMPRESSION: Findings suggesting mild vascular congestion. Substantial improvement in right infrahilar opacity. Persistent retrocardiac opacity, but decreased; although not entirely specific, probably explained by chronic atelectasis associated with a substantial hiatal hernia. Suspected small bilateral pleural effusions.

SubjectID: 10440642, StudyID: 58511476, Comparison: same

FINAL REPORT

INDICATION: Intubation. Evaluation of tube placement.

COMPARISON: ___, 4:07 a.m.

FINDINGS: ET tube terminates 2.1 cm above the carina. NG tube tip is in the stomach and the side hole may be above the diaphragm. There is otherwise no significant interval change   Keywords: no significant interval change.

SubjectID: 10440642, StudyID: 56383128, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Respiratory failure, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices are unchanged. However, there is a progression in extent and severity of the bilateral basal parenchymal opacities. These opacities are better characterized on the CT examination from ___ and are likely infectious in origin. Unchanged moderate cardiomegaly. Subtle blunting of the costodiaphragmatic sinuses could be caused by minimal pleural effusions.

SubjectID: 10440642, StudyID: 56122537, Comparison: same

FINAL REPORT

INDICATION: Hypoxia.

COMPARISON: ___ and ___.

FINDINGS: Moderate cardiomegaly is stable. However, a left lower lobe consolidation is worsened compared to ___. Moderate pleural effusion is likely. New interstitial opacities are seen throughout the left upper lobe. Right basilar opacities are chronic and unchanged   Keywords: unchanged. There is no pneumothorax.

SubjectID: 10440642, StudyID: 55577077, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Likely pneumonia, evaluation for interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the monitoring and support devices, in unchanged position. The pre-existing right basal lung opacity is minimally less dense and less extensive. On the left, however, the opacities at the lung base and in the left perihilar areas are unchanged. Also unchanged is the relatively extensive retrocardiac atelectasis as well as the moderate cardiomegaly. No larger pleural effusions can be seen on the chest radiograph. No evidence of pneumothorax.

SubjectID: 10440642, StudyID: 50333748, Comparison: None

FINAL REPORT

HISTORY: ___-year-old female with new right subclavian line placement, question pneumothorax.

COMPARISON: ___ at 6:56 a.m.

FINDINGS: A new right-sided subclavian line terminates within the right atrium. There is no pneumothorax. ET tube terminates 3 cm above the carina. Orogastric tube terminates within the stomach. Remainder of the chest is unchanged with continued left upper lobe patchy opacity, retrocardiac consolidation, small to moderate left pleural effusion, and chronic right basilar changes.

SubjectID: 10455855, StudyID: 55713866, Comparison: None

FINAL REPORT

CHEST, TWO VIEWS: ___

HISTORY: ___-year-old female with fall and right hip pain.

COMPARISON: ___.

FINDINGS: AP and lateral views of the chest. The lungs hyperinflated but clear of focal consolidation or edema. Blunting of the right posterior costophrenic angle is compatible with small effusion and appears somewhat smaller when compared to prior. The cardiac silhouette is enlarged but stable in configuration. Left chest wall dual-lead pacing device again seen with leads in similar position. No acute osseous abnormality is detected.

IMPRESSION: Hyperinflation and persistent small right effusion without acute cardiopulmonary process.

SubjectID: 10455855, StudyID: 55137113, Comparison: None

FINAL REPORT

HISTORY: Preoperative evaluation. Hip fracture.

COMPARISON: Multiple prior chest radiographs, the most recent of ___.

FINDINGS: Portable upright frontal view of the chest. Dual chamber pacer is noted. The aortic knob is calcified. Moderate to severe cardiomegaly is stable. There is no focal consolidation or overt pulmonary edema. Tiny right pleural effusion, if any. No left pleural effusion or pneumothorax.

IMPRESSION: Stable cardiomegaly. No overt pulmonary edema or focal opacity. Tiny right pleural effusion, if any.

SubjectID: 10504635, StudyID: 58363234, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with swan-ganz catheter // evaluate for swan-ganz catheter placement

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Mild cardiomegaly and widened mediastinum are unchanged. Swan-Ganz catheter tip is in the main pulmonary artery. There is no pneumothorax pleural effusion or pulmonary edema.

SubjectID: 10504635, StudyID: 52292686, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with swan // Evaluate position

TECHNIQUE: Single frontal view of the chest

COMPARISON: ___

IMPRESSION: Swan-Ganz catheter tip is in the main pulmonary artery. There is no evident pneumothorax or pleural effusion. . The lungs are clear. Cardiomediastinal contours are unchanged.

SubjectID: 10504635, StudyID: 57854196, Comparison: None

FINAL REPORT

INDICATION: ___M with SOB, EF of 20% // Eval for volume overload

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph ___, ___.

FINDINGS: Mildly enlarged cardiac silhouette is again noted. The mediastinal and hilar contours are unremarkable. There is no pleural effusion or pneumothorax. The lungs are well-expanded and clear without focal consolidation concerning for pneumonia. Pulmonary vasculature within is within normal limits.

IMPRESSION: Mildly enlarged cardiac silhouette; differential includes mild cardiomegaly or small pericardial effusion. Resolution of small right pleural effusion. No findings concerning for overt volume overload.

SubjectID: 10504635, StudyID: 53382066, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with h/o AML s/p allo-SCT, relapse, most recently received DLI, now w/ multisystem organ failure with decompensated CHF, ___, sig. transamnitis. // progression of heart failure

COMPARISON: Chest radiographs from___

FINDINGS: Heart size is top normal. The mediastinal and hilar contours are normal. The pulmonary vasculature is normal. No focal consolidation, pleural effusion, or pneumothorax. Lines and tubes: IABP tip is more proximal, less than 1cm below the aortic arch. More standard positioning may be achieved by pulling it back at least 1.5 cm. PA catheter tip position is similar to yesterday.

IMPRESSION: 1. Heart size is top-normal. No pulmonary vascular congestion or pleural effusion. 2. IABP tip is less than 1cm below the aortic arch. More standard positioning may be achieved by pulling it back at least 1.5 cm.

SubjectID: 10504635, StudyID: 56942858, Comparison: same

FINAL REPORT

INDICATION: Patient with AML, on induction chemotherapy complicated by pneumonia, now presenting with tachypnea and hypoxia. Evaluate for interval change in pneumonia or signs of congestive heart failure.

COMPARISON: Most recent chest radiograph from ___.

FINDINGS: A bedside AP radiograph of the chest demonstrates marked worsening of the dense airspace consolidation affecting the right upper and middle lobes and the left upper lobe. There is no marked change in the size of the cardiac silhouette or the mediastinum, which does feature persistent vascular engorgement   Keywords: persistent. There is no pneumothorax or pleural effusion, and the pulmonary vascularity is normal. A right-sided PICC terminates in the mid SVC.

IMPRESSION: 1. Worsening multifocal pneumonia. 2. Findings consistent with mild elevation of central venous pressure without signs of decompensated congestive heart failure. NOTE: Findings were communicated to Dr. ___ by Dr. ___ ___ telephone on ___ at 12:10 p.m., immediately after discovery.

SubjectID: 10504635, StudyID: 56797306, Comparison: worse

WET READ: ___ ___ ___ 7:01 PM Increased hazy opacification of the lower lung fields bilaterally, right greater than left, which may be technical or may represent subtle infiltrate. Increased prominence of the mediastinal veins, which may reflect intravascular volume status. Increased prominence of the pulmonary arteries compared to ___, which may be secondary to volume status or pulmonary parenchymal process, but pulmonary emboli should be considered, particularly in the setting of acute desaturation. If clinically indicated, CT could be performed for further evaluation. Discussed with Dr. ___ by phone at 6:58 p.m. on ___ at the time of initial review of the study. ______________________________________________________________________________

FINAL REPORT

PORTABLE CHEST ___ ___

COMPARISON: ___ radiograph.

FINDINGS: Cardiac silhouette is mildly enlarged, and accompanied by new pulmonary vascular congestion and bilateral perihilar haziness as well as increased distention of the azygous vein   Keywords: new, increase. Scattered interstitial opacities are also new   Keywords: new. Constellation of perihilar opacities and peripheral interstitial opacities favors pulmonary edema, but a coexisting opportunistic infection is also possible in this patient with immunosuppression. At the time of this dictation, a CTA has been performed and is dictated separately. Small pleural effusions are noted.

SubjectID: 10504635, StudyID: 50137818, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old man with AML, currently receiving chemotherapy. Patient with bleeding from the line. Evaluate line placement.

FINDINGS: Comparison is made to the prior radiographs from ___. Again seen is a right-sided central venous line with distal lead tip in the mid SVC. It is relatively unchanged when compared to the prior study. No pneumothoraces are seen. There is again seen diffuse perihilar airspace opacity compatible with patient's known multifocal pneumonia. Heart size is within normal limits.

SubjectID: 10504635, StudyID: 55070616, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with h/o AML s/p allo-SCT, relapse, most recently received DLI, now w/ multisystem organ failure with decompensated CHF, ___, sig. transamnitis. // please assess location of PA catheter, intraaortic balloon pump, and for pulmonary edema

COMPARISON: ___

IMPRESSION: As compared to the previous radiograph, the position of the Swan-Ganz catheter and of the aortic balloon pump are unchanged. The tip of the aortic balloon pump is still at the level of the upper limit of the aortic arch. The device could potentially be pulled back by several mm. No pneumothorax. No pleural effusions. No overt pulmonary edema. Mild cardiomegaly.

SubjectID: 10504635, StudyID: 53176653, Comparison: None

FINAL REPORT

INDICATION: Neutropenic fever, question pneumonia.

COMPARISON: ___.

TECHNIQUE: Single AP portable upright chest.

FINDINGS: Allowing for slight patient rotation, heart size and mediastinal contours are unchanged and within normal limits. There is new slight elevation of the left hemidiaphragm with linear opacity at the left lung base, consistent with atelectasis. No definite evidence of consolidation. No pleural effusion or definite evidence of pneumothorax; a linear density at the right lung apex likely relates to a skin fold. Osseous structures appear within normal limits.

IMPRESSION: New left basilar atelectasis, no definite evidence of consolidation.

SubjectID: 10504635, StudyID: 51970713, Comparison: None

FINAL REPORT

INDICATION: ___-year-old man with neutropenic fever and questionable pneumonia.

COMPARISON: ___.

TECHNIQUE: PA and lateral chest radiographs.

FINDINGS: Heart is normal size and cardiomediastinal contours are unremarkable. Lungs are well expanded and clear. No evidence of focal consolidation to suggest pneumonia. No pleural effusions and no pneumothorax. Left PICC is noted to terminate in the lower SVC.

IMPRESSION: No radiographic evidence of pneumonia.

SubjectID: 10526322, StudyID: 56029595, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old woman s/p PPM placement // ptx, lead placement

TECHNIQUE: CHEST (PA AND LAT)

COMPARISON: ___

IMPRESSION: Pacemaker leads terminate in the expected location of the right atrium and right ventricle. No evidence of pneumothorax is seen. Heart size and mediastinum are stable. No pleural effusion demonstrated. Replaced tricuspid valve is in unchanged position.

SubjectID: 10526322, StudyID: 53970807, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old woman s/p PPM placement // PTX, leads

TECHNIQUE: CHEST (PORTABLE AP)

COMPARISON: ___

IMPRESSION: Lead right-sided pacemaker has been placed with the 2 leads terminating in the expected location of right atrium and right ventricle. There is no pneumothorax. Cardiomegaly is mild, unchanged. Sternotomy wires are stable. Replaced tricuspid valve is in unchanged position. No pleural effusion is seen. No pneumothorax is seen.

SubjectID: 10532326, StudyID: 53897449, Comparison: None

FINAL REPORT

INDICATION: Nausea and vomiting. Presenting with AFib with RVR.

COMPARISON: ___ and concurrent CT abdomen and pelvis of ___.

FINDINGS: PA and lateral chest radiographs demonstrate low lung volumes and distended bowel as described on concurrent CT abdomen/pelvis. There are patchy opacities suggesting minor dependent bibasilar atelectasis. There is persistent cardiomegaly. There is no pneumothorax or pleural effusion. Suggestion of pulmonary venous hypertension is unchanged from prior radiograph.

SubjectID: 10532326, StudyID: 51742525, Comparison: None

FINAL REPORT

PORTABLE AP CHEST X-RAY

INDICATION: Patient with atrial fibrillation and small-bowel obstruction. NG tube position.

COMPARISON: ___.

FINDINGS: The nasogastric tube is in adequate position and there is a resolution of the gastric distention. There is still mild bibasilar atelectasis. There are no pneumothorax no pleural effusion. The cardiac and mediastinal contour are unchanged.

CONCLUSION: The nasogastric tube is in adequate position and there is resolution of the gastric distention.

SubjectID: 10532853, StudyID: 59565748, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with alc cirrhosis, bilateral PE, empyema with chest tubes // evaluate chest tube, pneumothorax evaluate chest tube, pneumothorax

IMPRESSION: In comparison with the study of ___, there is little change in the areas of localized air- levels consistent with the known empyema   Keywords: little change. Left chest tube at the base of the lung is again seen, with no evidence of pneumothorax. Opacification along the right lateral chest wall is again seen. The left lung is essentially clear. Substantial enlargement of the cardiac silhouette persists, though there is no evidence of pulmonary vascular congestion   Keywords: persists.

SubjectID: 10532853, StudyID: 55156948, Comparison: same

FINAL REPORT

INDICATION: ___ year old man with cirrhosis, bilateral pe, empyema // evaluate chest tubes, empyema, pneumothorax

TECHNIQUE: Chest PA and lateral

FINDINGS: In comparison with the study of ___, there is minimal increase in the areas of pleural air and fluid loculations consistent with the known empyema. Opacification along the right lateral chest wall is again seen. Right chest tube at the base of the lung is again seen. The left lung is essentially clear. Substantial enlargement of the cardiac silhouette persists, though there is no evidence of pulmonary vascular congestion   Keywords: persists.

IMPRESSION: Minimal increase in the right-sided loculated hydro pneumothorax.

SubjectID: 10532853, StudyID: 54730382, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with alcohol cirrhosis, bilateral PE, empyema // evaluate post chest tube removal; please do at 230 pm

TECHNIQUE: Chest PA and lateral

COMPARISON: ___ 8 at 10:00

FINDINGS: There has been interval removal of the right upper chest tube. The right lower chest tube is still in place. There is a the right-sided pneumothorax inferolaterally in the region where the lower portion of the chest tube was previously located. An air-fluid level is seen in this region compatible with a hydro pneumothorax. The heart size continues to be moderately enlarged. There is a small left effusion.

IMPRESSION: Increased right pneumothorax status post removal of the upper chest tube

SubjectID: 10532853, StudyID: 54079393, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with R chest tube s/p VATS // evaluate for CT placement

TECHNIQUE: Chest two views

COMPARISON: ___.

IMPRESSION: The 2 right-sided chest tubes are again visualized. There has been interval improved aeration of the left lung and right upper lobe. There continues to be hazy alveolar infiltrate involving the right lower lung dense consolidation/volume loss in the right lower lobe there small bilateral effusions there is no pneumothorax. The heart continues to be severely enlarged.

SubjectID: 10532853, StudyID: 52999640, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: ___ year old man with cirrhosis, bilateral PE and exudative effusion // eval pulm effusion, chest tubes; please do in am for ct surg to eval

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: Prior radiographs on ___

FINDINGS: Compared with prior radiographs on ___, the previously seen right-sided inferior lateral hydropneumothorax is smaller than previous, and again contains an air-fluid level. Again seen is a small left pleural effusion. A right lower chest tube is unchanged in position. There is no new focal consolidation. The cardiac and mediastinal silhouettes are unchanged.

IMPRESSION: Decrease in size in right-sided hydro pneumothorax.

SubjectID: 10532853, StudyID: 52593517, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___ year old man with Hep C/EtOH cirrhosis s/p VATS evacuation of R hemothorax, now w/ R chest tube removed. // Assess for interval change in R hemithorax post chest tube removal. Assess for interval change in R hemithorax post chest tube removal.

IMPRESSION: Compared to ___, 09:15, the right chest tube has been removed. The extent of the loculated right effusion is unchanged. Unchanged moderate to severe cardiomegaly, without evidence of pulmonary edema.

SubjectID: 10532853, StudyID: 59216710, Comparison: None

WET READ: ___ ___ ___ 7:52 AM Compared with the chest radiograph from earlier on the same date, there is worsening opacification of the right lung field, in keeping with history of worsening hemothorax and bloody pleural fluid from the chest catheter. There has been no change to the position of the right pleural catheter. The trachea is now midline; previously it was deviated slightly to the right due to volume loss. Left upper lung is grossly clear. The above findings were communicated via telephone by Dr. ___ to Dr. ___ at 20:17 on ___, ___ min after discovery.

WET READ VERSION #1 ___ ___ ___ 8:19 PM Compared with the chest radiograph from earlier on the same date, there is worsening opacification of the right lung field, in keeping with history of worsening hemothorax and bloody pleural fluid from the chest catheter. There has been no change to the position of the right pleural catheter. The trachea is now midline; previously it was deviated slightly to the right due to volume loss. Left upper lung is grossly clear. The above findings were communicated via telephone by Dr. ___ to Dr. ___ at 20:17 on ___, ___ min after discovery. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with worsening anemia and chest tube with bloody pleural fluid. // evaluate for worsening effusion, consolidation evaluate for worsening effusion, consolidation

COMPARISON: Comparison to ___ at 09:38

FINDINGS: Portable semi-erect chest radiograph ___ at 19:49 is submitted.

IMPRESSION: Interval increase in size of large layering right pleural collection consistent with hemothorax given history of bloody pleural fluid coming from the chest tube. Right chest tube remains unchanged in position. There is now slight shift to the mediastinal and cardiac structures to the left. There is improved aeration at the left base with interval appearance of patchy opacity in the left mid lung which may reflect an area of atelectasis, although pneumonia cannot be excluded. No pneumothorax. Heart remains enlarged.

SubjectID: 10532853, StudyID: 53292365, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with right empyema and chest tube in place. // Interval change? Interval change?

COMPARISON: Comparisons to ___ at 07:19

FINDINGS: Portable semi-erect chest radiograph ___ at 938 is submitted.

IMPRESSION: A right pleural catheter remains in place and there is a slightly smaller but persistent apical lateral pneumothorax. Overall, there is improving aeration at the right base with decrease in size of the pleural collection. The heart remains markedly enlarged which may reflect cardiomegaly, although a pericardial effusion cannot be excluded. Opacity at the left base most likely reflects partial lower lobe atelectasis, although pneumonia cannot be excluded. No evidence of pulmonary edema.

SubjectID: 10532853, StudyID: 52292676, Comparison: same

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with h/o ETOH/HCV cirrhosis presenting with pneumohemothorax on R side, with 2 chest tubes for drainage // interval change

IMPRESSION: Compared to previous radiograph from 1 day earlier, a right chest tube remains in place. The moderate to large loculated right effusion has slightly decreased in size with increase in hydro pneumothorax component laterally. The slight improvement in adjacent opacities in the right mid and lower lung. No other relevant change since recent study   Keywords: no other relevant change.

SubjectID: 10532853, StudyID: 51986541, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with hydro/pnuemo/hemothorax with ___F CT in place with very poor drainage. // Interval change? Interval change?

COMPARISON: Comparison to ___ at 19:49

FINDINGS: Portable AP upright chest radiograph ___ 01:14 is submitted.

IMPRESSION: Right chest tube remains unchanged in position. There continues to be near complete opacification of the right hemithorax likely due to a large pleural collection. There continues to be slight leftward shift of the mediastinal structures. A tiny amount of air is seen at the left apex consistent with a small pneumothorax. Streaky opacities in the left lung likely reflect atelectasis. There is possibly a small left effusion as the costophrenic angle appears blunted. The heart remains stably enlarged. No evidence of pulmonary edema.

SubjectID: 10532853, StudyID: 56370428, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with new right sided chest tube

TECHNIQUE: Portable upright AP view of the chest

COMPARISON: ___ 08:20

FINDINGS: There has been interval placement of a new right basilar chest tube with tip projecting along the mid right mediastinal contour. There is a continued moderate size right pleural effusion, perhaps slightly decreased in size compared to the previous study with continued right basilar opacity, potentially atelectasis. No pneumothorax is identified. Left lung remains clear. Heart size is moderately enlarged, and mediastinal and hilar contours are similar.

IMPRESSION: Interval placement of new right basilar chest tube with slightly decreased size of moderate right pleural effusion. Continued right basilar opacity, potentially atelectasis though infection is not excluded. No pneumothorax.

SubjectID: 10532853, StudyID: 55459306, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with etoh and hep c cirrhosis, CHF EF ___%, now with pleural effusion s/p chest tube placement. Please perform at 5AM. // chest tube placement, pleural effusion, infiltrates. PLEASE PERFORM AT 5 AM. chest tube placement, pleural effusion, infiltrates. PLEASE PERFORM AT 5 AM.

IMPRESSION: As compared to the previous image, the right chest tube is in unchanged position. Unchanged small lateral right-sided pneumothorax. The extent of the right basilar atelectasis has minimally increased. Global and relatively massive cardiac enlargement. No pneumothorax. Normal appearance of the left lung.

SubjectID: 10532853, StudyID: 55081250, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PA AND LAT)

INDICATION: ___M with r shoulder/back pain, history of CHF and cirrhosis.

COMPARISON: ___.

FINDINGS: PA and lateral views of the chest provided. There is interval increase in right pleural effusion now moderate in size with associated consolidation in the right lower lung likely representing atelectasis though difficult to exclude a superimposed pneumonia. The left lung appears clear. Cardiomegaly is again noted. There is no overt evidence for pulmonary edema. The bony structures are intact.

IMPRESSION: Persistent cardiomegaly with increasing right pleural effusion and right mid and lower lung atelectasis, difficult to exclude a superimposed pneumonia.

SubjectID: 10532853, StudyID: 55468077, Comparison: None

FINAL REPORT

EXAMINATION: CHEST (PORTABLE AP)

INDICATION: ___ year old man with right chest tube for empyema // Interval change? Interval change?

IMPRESSION: In comparison with the earlier study of this date, the degree of loculated air at the right base has decreased. The overall effusion on the right seen is little change despite the presence of a chest tube. Otherwise, little change in the appearance of the heart and lungs.

SubjectID: 10532853, StudyID: 51409686, Comparison: None

FINAL REPORT

EXAMINATION: Chest: Frontal and lateral views

INDICATION: ___ year old man with h/o r chest tubes // Evaluate stability of hydro and pneumothorax

TECHNIQUE: Chest: Frontal and Lateral

COMPARISON: Prior radiographs on ___

FINDINGS: Compared with prior radiographs on ___, there is no significant change in the extent of the loculated right hydropneumothorax.The left lung is clear without focal consolidation, effusion or pneumothorax. Cardiomegaly is unchanged.

IMPRESSION: No significant change in right loculated hydropneumothorax.

SubjectID: 10533554, StudyID: 59613716, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chylothorax on the right, chest tube placement. Evaluation for pneumothorax.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the patient has received a right pleural catheter. There is substantial decrease in extent of the pre-existing pleural fluid collection. Small collection persists at the bases of the right hemithorax. Associated atelectasis is also seen. Minimal left pleural effusion is unchanged. Unchanged appearance of the cardiac silhouette.

SubjectID: 10533554, StudyID: 51650480, Comparison: None

FINAL REPORT

EXAM: Chest frontal and lateral views. CLINICAL INFORMATION: Dyspnea.

COMPARISON: ___.

FINDINGS: There has been interval development of a significant increase in opacity projecting over the right hemithorax worrisome for worsening loculated/multiloculated pleural effusion with possible areas of underlying consolidation. The right aspect of the cardiac silhouette is not well assessed due to the adjacent opacity at the cardiac silhouette is grossly stable and mildly enlarged. The aorta is calcified and tortuous. Again seen is a left-sided subclavian central venous catheter terminating in the region of the low SVC. Surgical clips are again seen projecting over the posterior lower mediastinum. There may be a trace left pleural effusion. No pneumothorax is seen.

IMPRESSION: Interval significant increase in opacity projecting over the right hemithorax worrisome for worsen loculated/multiloculated pleural effusion with possible areas of consolidation. Possible trace left pleural effusion.

SubjectID: 10533554, StudyID: 58604390, Comparison: None

FINAL REPORT

HISTORY: History of right chylothorax, status post thoracentesis.

TECHNIQUE: Frontal and lateral radiographs were obtained.

COMPARISON: Comparison is made to radiographs dated ___, and ___. Comparison is also made to CT chest dated ___.

FINDINGS: Redemonstrated is a left central port, unchanged in location. As compared to chest radiographs dated ___, there has been partial improvement in the airspace opacities affecting the right lung base and right perihilar region. A stable, small right pleural effusion is noted. There is no new focus of consolidation identified. The left lung is grossly clear, and there is no evidence of pneumothorax. Stable, mild to moderate cardiomegaly is appreciated.

IMPRESSION: Interval improvement in the right perihilar and right lung base airspace opacification.

SubjectID: 10533554, StudyID: 56851318, Comparison: None

FINAL REPORT

PORTABLE CHEST ___ WITH

COMPARISON STUDY OF EARLIER THE SAME DAY

FINDINGS: Following right thoracentesis, a right pleural effusion has substantially decreased in size with only a small residual effusion remaining. There is a probable tiny right apical pneumothorax. Heterogeneous opacities in the right mid and lower lung likely represent reexpansion edema in the setting of recent large volume thoracentesis.

SubjectID: 10533554, StudyID: 51347473, Comparison: None

FINAL REPORT

PORTABLE UPRIGHT CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: Interval worsening of airspace opacities at the right lung base, now extending to the right perihilar region. Considering recent large volume thoracentesis, this may reflect reexpansion pulmonary edema. Small residual right pleural effusion is present, but there is no evidence of a pneumothorax.

SubjectID: 10533554, StudyID: 50966674, Comparison: None

FINAL REPORT

PATIENT

HISTORY: ___-year-old woman with chylothorax, please do evaluation, compare to chest x-ray for assessment of reaccumulation.

FINDINGS: As compared to prior chest x-ray of ___,, right pleural effusion has increased, now moderate. Left lung is clear. Heart size is mildly enlarged. No pulmonary edema or pneumothorax. The left PICC is unchanged ending in lower SVC.

IMPRESSION: Intervale increase of right pleural effusion, now moderate.

SubjectID: 10533554, StudyID: 57534685, Comparison: None

FINAL REPORT

HISTORY: Evaluation of effusion

TECHNIQUE: PA and lateral views of the chest.

COMPARISON: Multiple chest radiographs the most recent on ___.

FINDINGS: A right pigtail drain is seen at the base of the right lung, unchanged in position. A left central venous catheter is seen terminating in the low SVC and unchanged. There is some opacity at the base of the right lung which likely represents increased atelectasis, however may also represent pneumonia or pulmonary hemorrhage in the appropriate clinical setting. There is possibly a new loculated right pleural effusion. There is a small pleural effusion on the left. The cardiomediastinal silhouette and hilar contours are grossly unchanged. There is no pneumothorax.

IMPRESSION: Opacity at the base of the right lung which likely represents increased atelectasis, however may also represent pneumonia or pulmonary hemorrhage in the appropriate clinical setting.

SubjectID: 10533554, StudyID: 50599835, Comparison: worse

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman status post VATS surgery and thoracic duct ligation.

FINDINGS: Comparison is made to the previous study from ___. There is a right basilar pigtail catheter. No pneumothoraces are seen. There is also a left-sided subclavian catheter with distal lead tip at the cavoatrial junction. Heart size is upper limits of normal. There is again seen consolidation at the right base which may represent developing pneumonia or atelectasis. There are bilateral pleural effusions. There is mild pulmonary edema which has developed since the prior study   Keywords: develop.

SubjectID: 10533554, StudyID: 57073451, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Radiograph of two days earlier.

FINDINGS: Right pigtail pleural catheter is in place, with interval decrease in size of right pleural effusion with residual small effusion remaining, and no visible pneumothorax. Cardiomediastinal contours are stable in appearance. Interval improvement in heterogeneous opacities in the right mid and bilateral lower lung regions, as well as decrease in size of a small left pleural effusion.

SubjectID: 10533554, StudyID: 54740343, Comparison: None

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: ___ radiograph.

FINDINGS: A very large right pleural effusion has increased in size from the prior radiograph, and occupies almost the entirety of the right hemithorax with only a small amount of residual aerated right upper lobe at the apex. A small-to-moderate left pleural effusion has only slightly increased in size from the prior radiograph and is associated with adjacent atelectasis at the left lung base.

SubjectID: 10533554, StudyID: 52052678, Comparison: None

FINAL REPORT

PORTABLE CHEST ___

COMPARISON: Radiograph of one day earlier.

FINDINGS: Large right pleural effusion has further increased in size and now occupies the entirety of the right hemithorax, with associated leftward shift of the cardiomediastinal contours. Hemothorax should be considered if the patient has had recent intervention, trauma or has known coagulation disorder. Left lung and pleural surfaces are grossly clear allowing for some crowding of bronchovascular structures related to the leftward cardiomediastinal shift.

SubjectID: 10533554, StudyID: 56759171, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Chylothorax, status post VATS, thoracic duct ligation, evaluation for interval change.

COMPARISON: ___.

FINDINGS: The position of the right chest tube is unchanged. On the current image, there is no longer a visualization of a right pneumothorax. No pleural effusion. Overall, decreased lung volumes. Unchanged appearance of the left lung and of the cardiac silhouette.

SubjectID: 10533554, StudyID: 55968851, Comparison: None

FINAL REPORT

CHEST RADIOGRAPH

INDICATION: Evaluation for post-operative interval change.

COMPARISON: ___.

FINDINGS: As compared to the previous radiograph, the position of the right chest tube is slightly changed. In unchanged manner, there is a millimetric right apical pneumothorax. No evidence of tension, no parenchymal opacities. Unchanged appearance of the heart, unchanged left Port-A-Cath.

SubjectID: 10533554, StudyID: 52578056, Comparison: None

FINAL REPORT

HISTORY: VATS ligation of thoracic duct, to assess for chylothorax.

FINDINGS: In comparison with the study of ___, the right chest tube remains in place. There is probably a small apical pneumothorax. Opacification at the right base in the costophrenic angle is consistent with fluid in the pleural space and some atelectasis. There is opacification at the left base with silhouetting of the hemidiaphragms, consistent with volume loss in the left lower lobe and pleural effusion.

SubjectID: 10533554, StudyID: 56633027, Comparison: better

FINAL REPORT

STUDY: AP chest, ___ at 8:05 a.m.: CLINICAL

HISTORY: Patient with pulmonary edema and CHF exacerbation.

FINDINGS: Comparison is made to previous study performed six hours earlier. There is improvement of pulmonary edema   Keywords: improve. There remains bilateral pleural effusions, right side greater than left. The effusion on the left side is slightly decreased. Left-sided central line is unchanged in position with distal lead tip at the cavoatrial junction.

SubjectID: 10533554, StudyID: 52812105, Comparison: same

FINAL REPORT

STUDY: AP Chest, ___: CLINICAL

HISTORY: ___-year-old woman with worsening dyspnea. Evaluate for pulmonary edema.

FINDINGS: Comparison is made to previous study from ___. There is a left-sided central line with its distal lead tip at the cavoatrial junction. There are unchanged large bilateral pleural effusions. There is again seen pulmonary edema which is moderate   Keywords: again. There is no pneumothoraces. The heart size is enlarged.

SubjectID: 10533554, StudyID: 51424589, Comparison: None

FINAL REPORT

STUDY: AP chest, ___. CLINICAL

HISTORY: ___-year-old woman with CHF exacerbation.

FINDINGS: Comparison is made to study from ___. There is a left-sided central line with its distal lead tip at the cavoatrial junction. There are unchanged large bilateral pleural effusions, right side slightly greater than left. There are no pneumothoraces.

SubjectID: 10533554, StudyID: 53552442, Comparison: worse

FINAL REPORT

PORTABLE CHEST, ___

COMPARISON: Study of one day earlier.

FINDINGS: Right chest tube in place with slight increase in size of a small right apical pneumothorax. Cardiomediastinal contours are stable allowing for patient rotation. Mild pulmonary vascular congestion is present as well as worsening bibasilar opacities, particularly in the left retrocardiac region and periphery of right lung base   Keywords: worse. Small pleural effusions are again demonstrated.

SubjectID: 10533554, StudyID: 56102921, Comparison: better

FINAL REPORT

PA AND LATERAL CHEST, ___

COMPARISON: Radiographs of ___.

FINDINGS: Right pigtail pleural catheter remains in place, with interval increase in size of a small right apical pneumothorax, with apical visceral pleural line just below the right third posterior rib level. Right pleural effusion has further decreased in size with small residual effusion remaining. Nonspecific right lower lobe opacities, possibly representing reexpansion pulmonary edema, show further interval improvement   Keywords: improve. Left lung remains clear, and there is no evidence of left pleural effusion. Cardiomediastinal contours are stable.

IMPRESSION: Increasing small right apical pneumothorax with pleural catheter in place. Small residual right pleural effusion and improving adjacent right lower lobe opacities, possibly representing reexpansion pulmonary edema in the setting of recent history of large volume thoracentesis   Keywords: improving.

SubjectID: 10533554, StudyID: 53893735, Comparison: None

FINAL REPORT

HISTORY: Chylothorax, assess for interval change.

TECHNIQUE: Frontal and lateral chest radiographs were obtained.

COMPARISON: Comparison is made to radiographs dated ___.

FINDINGS: As compared to the prior examination dated ___, there has been an interval increase in size of the right pleural effusion, now moderate to severe in size. The right upper lung field and left lung are grossly unremarkable without focal consolidation, pneumothorax, or pulmonary edema. There is stable, mild cardiomegaly. Mediastinal contours are normal. The left-sided central venous line remains in an unchanged position, seen terminating in the lower SVC.

IMPRESSION: Interval increase in the right pleural effusion, now occupying roughly half of the right hemi-thorax.

SubjectID: 10533554, StudyID: 50862149, Comparison: None

FINAL REPORT

AP CHEST 7:59 A.M., ___

HISTORY: An ___-year-old woman with a chylothorax after drainage. Please assess for interval change or pleural effusion.

IMPRESSION: AP chest compared to ___: Minimal if any right pleural effusion. Small right apical pneumothorax essentially unchanged. Lungs grossly clear. Heart size normal. Right pleural drain unchanged in position. Left subclavian line ends in the low SVC.

SubjectID: 10533554, StudyID: 50207921, Comparison: same

FINAL REPORT

HISTORY: Chest tube placement for chylothorax.

FINDINGS: In comparison with study of earlier in this date, there has been placement of a left chest tube drainage of a substantial amount of fluid from the right chest. Small effusion and residual atelectasis or reexpansion edema is seen. Otherwise, little change   Keywords: little change.

SubjectID: 10533554, StudyID: 55771288, Comparison: better

FINAL REPORT

INDICATION: ___ y.o. F ___ speaking with multiple medical issues most notable for HTN, CAD, Afib not on anticoagulation, systolic CHF (LVEF ___%), and diffuse large B cell lymphoma on Rituximab presents with cough and dyspnea. Evaluate for interval change.

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph from ___

FINDINGS: Lung volumes are low, unchanged from prior. Heterogeneous, asymmetrically distributed opacities remain more severe on the right than the left and show interval improvement, particularly in the left lungCardiomegaly is unchanged.Mediastinal and hilar contours are unremarkable. There is no evidence for pulmonary consolidation, pleural effusion, or pneumothorax.Left subclavian port tip terminates in the upper SVC, unchanged from prior.

IMPRESSION: Improving heterogeneous lung opacities   Keywords: improving. Rapid change suggests pulmonary edema, though underlying pneumonia in the right lung should be considered in the appropriate clinical setting.

SubjectID: 10533554, StudyID: 53969994, Comparison: None

WET READ: ___ ___ ___ 2:13 PM Moderate pulmonary edema with small bilateral pleural effusions and mild cardiomegaly. ______________________________________________________________________________

FINAL REPORT

EXAMINATION: Chest radiograph.

INDICATION: ___F with sob. Assess for pneumonia or congestive heart failure.

TECHNIQUE: Single portable supine frontal chest radiograph.

COMPARISON: Chest radiograph ___, CT chest with contrast ___.

FINDINGS: Moderate diffuse perihilar interstitial and alveolar opacities, right greater than left, with air bronchograms. The lungs are mildly hypoinflated. Small bilateral pleural effusions. No pneumothorax. Mild cardiomegaly is stable. Mediastinal contour is unremarkable. Left subclavian port tip in the upper SVC. Mediastinal clips noted.

IMPRESSION: 1. Moderate diffuse bilateral, right greater than left, opacities could represent severe pulmonary edema however pneumonia cannot be excluded. Clinical correlation recommended. 2. Small bilateral pleural effusions and mild cardiomegaly.

RECOMMENDATION(S): The findings were discussed by Dr. ___ with Dr. ___ on the ___ ___ at 4:09 PM, 5 minutes after discovery of the findings.

SubjectID: 10533554, StudyID: 55720364, Comparison: None

FINAL REPORT

EXAMINATION: Chest

INDICATION: ___ year old woman with pleural effusion // eval

TECHNIQUE: Chest PA and lateral

COMPARISON: Chest radiograph PA and lateral ___

FINDINGS: Biapical pleural scarring, stable since the prior radiograph. There is a small to moderate right pleural effusion, not significantly changed from the prior CXR. There are bilateral post-radiation fibrotic changes which are better characterized by the prior CT on ___. Lateral view demonstrates a triangular opacity projecting over the heart, consistent with RML volume loss. Stable cardiomediastinal silhouette. Mild pulmonary vascular congestion. Left subclavian line terminates in the distal SVC. No acute osseous abnormalities.

IMPRESSION: 1. Small to moderate right pleural effusion is not significantly changed. 2. Stable post radiation fibrotic changes with associated volume loss. 3. Mild pulmonary vascular congestion.